Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA.
Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Zoonoses Public Health. 2020 Jun;67(4):407-415. doi: 10.1111/zph.12699.
An estimated 300,000 cases of Lyme disease occur in the United States annually. Disseminated Lyme disease may result in carditis, arthritis, facial palsy or meningitis, sometimes requiring hospitalization. We describe the epidemiology and cost of Lyme disease-related hospitalizations. We analysed 2005-2014 data from the Truven Health Analytics MarketScan Commercial Claims and Encounters Databases to identify inpatient records associated with Lyme disease based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We estimated the annual number and median cost of Lyme disease-related hospitalizations in the United States in persons under 65 years of age. Costs were adjusted to reflect 2016 dollars. Of 20,983,165 admission records contained in the inpatient databases during the study period, 2,823 (0.01%) met inclusion criteria for Lyme disease-related hospitalizations. Over half of the identified records contained an ICD-9-CM code for meningitis (n = 614), carditis (n = 429), facial palsy (n = 400) or arthritis (n = 377). Nearly 60% of hospitalized patients were male. The median cost per Lyme disease-related hospitalization was $11,688 (range: $140-$323,613). The manifestation with the highest median cost per stay was carditis ($17,461), followed by meningitis ($15,177), arthritis ($13,012) and facial palsy ($10,491). Median cost was highest among the 15- to 19-year-old age group ($12,991). Admissions occurring in January had the highest median cost ($13,777) for all study years. Based on extrapolation to the U.S. population, we estimate that 2,196 Lyme disease-related hospitalizations in persons under 65 years of age occur annually with an estimated annual cost of $25,826,237. Lyme disease is usually treated in an outpatient setting; however, some patients with Lyme disease require hospitalization, underscoring the need for effective prevention methods to mitigate these serious cases. Information from this analysis can aid economic evaluations of interventions that prevent infection and advances in disease detection.
据估计，每年美国有 30 万例莱姆病病例。播散性莱姆病可能导致心炎、关节炎、面瘫或脑膜炎，有时需要住院治疗。我们描述了莱姆病相关住院的流行病学和费用。我们分析了 2005-2014 年 Truven Health Analytics MarketScan 商业索赔和就诊数据库的数据，根据国际疾病分类，第九修订版，临床修正版（ICD-9-CM）代码，确定与莱姆病相关的住院记录。我们估计了在美国 65 岁以下人群中与莱姆病相关的住院人数和中位数成本。费用经过调整，以反映 2016 年的美元。在研究期间，住院数据库中包含 20983165 份入院记录，其中 2823 份（0.01%）符合莱姆病相关住院标准。确定的记录中超过一半包含脑膜炎（n=614）、心炎（n=429）、面瘫（n=400）或关节炎（n=377）的 ICD-9-CM 代码。近 60%的住院患者为男性。与莱姆病相关的每次住院的中位数费用为 11688 美元（范围：140-323613 美元）。每个住院病例费用最高的表现是心炎（$17461），其次是脑膜炎（$15177）、关节炎（$13012）和面瘫（$10491）。15-19 岁年龄组的中位数费用最高（$12991）。所有研究年份中，1 月住院的中位数费用最高（$13777）。根据对美国人口的推断，我们估计每年有 2196 例 65 岁以下人群的莱姆病相关住院治疗，估计每年的费用为 25826237 美元。莱姆病通常在门诊治疗；然而，一些莱姆病患者需要住院治疗，这突出表明需要有效的预防方法来减轻这些严重病例。本分析提供的信息可以帮助评估预防感染和疾病检测进展的干预措施的经济效果。
