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牙周病管理对 2 型糖尿病患者的医疗支出、住院和糖尿病恶化的影响:使用日本医疗、牙科和药房理赔数据的观察性研究。

Effects of periodontal management for patients with type 2 diabetes on healthcare expenditure, hospitalization and worsening of diabetes: an observational study using medical, dental and pharmacy claims data in Japan.

机构信息

Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

J Clin Periodontol. 2021 Jun;48(6):774-784. doi: 10.1111/jcpe.13441. Epub 2021 Mar 10.

DOI:10.1111/jcpe.13441
PMID:33544396
Abstract

AIMS

To investigate the effects of regular periodontal management for people with type 2 diabetes on total healthcare expenditure, hospitalization and the introduction of insulin.

MATERIALS AND METHODS

We collected data of individuals who were prescribed diabetes medications during the fiscal year 2015 from the claims database of a prefecture in Japan. We fitted generalized linear models that had sex, age, comorbidities and the status of periodontal management during the previous two years as predictors.

RESULTS

A total of 16,583 individuals were enrolled. The annual healthcare expenditure in the third year was 4% less (adjusted multiplier 0.96, 95% confidence interval [CI] 0.92-1.00) in the group receiving periodontal management every year. The adjusted odds ratio (aOR) for all-cause hospitalization was 0.90 (95% CI: 0.82-0.98). The aOR of introducing insulin in the third year for those who had not been prescribed insulin during the previous two years (n = 13,222) was 0.77 (95% CI: 0.64-0.92) in the group receiving periodontal management every year.

CONCLUSION

Regular periodontal management for diabetic people was associated with reduced healthcare expenditure, all-cause hospitalization and the introduction of insulin therapy.

摘要

目的

研究 2 型糖尿病患者定期进行牙周治疗对总医疗支出、住院和胰岛素使用的影响。

材料与方法

我们从日本某县的理赔数据库中收集了 2015 财政年度服用糖尿病药物的个体数据。我们拟合了广义线性模型,将性别、年龄、合并症以及前两年的牙周治疗状况作为预测因子。

结果

共纳入 16583 人。在第三年,接受每年一次牙周治疗的患者的年度医疗支出减少了 4%(调整后的乘数为 0.96,95%置信区间为 0.92-1.00)。全因住院的调整后比值比(aOR)为 0.90(95%置信区间:0.82-0.98)。对于在前两年未开胰岛素的 13222 名患者,在第三年开始使用胰岛素的 aOR 在每年接受牙周治疗的患者中为 0.77(95%置信区间:0.64-0.92)。

结论

定期对糖尿病患者进行牙周治疗与降低医疗支出、全因住院和胰岛素治疗的引入有关。

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