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坐骨神经痛患者队列的医疗支出及其预测因素。

Healthcare expenditure and its predictors in a cohort of Australians living with sciatica.

机构信息

The George Institute for Global Health, University of New South Wales, Level 5, 1 King Street, Newtown, Sydney, 2041, Australia.

The Institute for Musculoskeletal Health, Sydney, Australia.

出版信息

Eur Spine J. 2021 Apr;30(4):878-885. doi: 10.1007/s00586-020-06605-2. Epub 2020 Sep 24.

Abstract

PURPOSE

To estimate the healthcare resource utilisation of an Australian cohort of people with sciatica and explore individual-level factors associated with expenditure.

METHODS

Healthcare utilisation (services and medication) data from a randomised, double-blind, placebo-controlled trial of pregabalin in patients with sciatica (n = 185) were analysed to estimate healthcare expenditure of participants over 12 months. Associations between key baseline socio-economic, pain and quality of life characteristics and healthcare expenditure were examined using generalised linear imputation models.

RESULTS

On average, participants accessed AUD$1,134 of healthcare over the year, predominantly made up of $114 of medication and $914 of health services, which included $418 of physiotherapy services. Participants randomised to receive pregabalin incurred higher expenditure ($1,263 compared to $1,001 for placebo), which was largely driven by pregabalin ($158) and greater health services ($107). Healthcare expenditure was significantly higher for participants prescribed pregabalin, earning greater than $1,700 per week ($88,400 per year) and reporting poorer quality of life (physical and mental).

CONCLUSION

Our results suggest inefficiency in the use of healthcare resources due to increased healthcare resource utilisation in people with sciatica treated with pregabalin, compared to placebo. Costs of treating sciatica varied based on individual quality of life and socio-economic characteristics.

摘要

目的

评估澳大利亚坐骨神经痛患者队列的医疗资源利用情况,并探讨与支出相关的个体水平因素。

方法

对接受普瑞巴林治疗坐骨神经痛的随机、双盲、安慰剂对照试验(n=185)中的患者的医疗保健利用(服务和药物)数据进行分析,以估计参与者在 12 个月内的医疗保健支出。使用广义线性推断模型检查关键基线社会经济、疼痛和生活质量特征与医疗保健支出之间的关联。

结果

平均而言,参与者在一年内获得了 1134 澳元的医疗保健服务,主要包括 114 澳元的药物和 914 澳元的医疗服务,其中包括 418 澳元的物理治疗服务。接受普瑞巴林治疗的参与者支出更高(1263 澳元比安慰剂组的 1001 澳元),这主要是由普瑞巴林(158 澳元)和更多的医疗服务(107 澳元)导致的。接受普瑞巴林治疗的参与者的医疗保健支出明显更高,每周收入超过 1700 澳元(每年 88400 澳元),且生活质量(身体和精神)更差。

结论

我们的研究结果表明,与安慰剂相比,接受普瑞巴林治疗的坐骨神经痛患者的医疗资源利用增加,导致医疗资源使用效率低下。坐骨神经痛的治疗成本因个体生活质量和社会经济特征而异。

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