IPAM e.V., Alter Holzhafen 19, 23966, Wismar, Germany.
Janssen Pharmaceutica, Beerse, NV, Belgium.
Int J Colorectal Dis. 2021 Apr;36(4):831-840. doi: 10.1007/s00384-021-03876-z. Epub 2021 Feb 10.
Use claims data to assess healthcare resource utilization (HCRU) and cost for patients with ulcerative colitis (UC) who had surgery and patients who did not.
UC patients from a German health insurance were included between 01/01/2010-31/12/2017. Patients with proctocolectomy or colectomy between 01/07/2010 and 31/12/2014 were identified, and surgery date was set as index. For patients with IPAA, the last surgery in the 6 months was taken as index. Non-surgery patients received random index. After propensity score matching, UC-related HCRU and cost were observed for three years post-index.
Of 21,392 UC patients, 85 underwent surgery and 2655 did not. After matching, 76 were included in the surgery group and 114 in the non-surgery group. Matched cohorts did not differ in baseline characteristics and mortality rates where high in both groups (21.1% and 29.0%, respectively). The percentage of patients with at least one hospitalization in the follow-up period was higher in the surgery (53.9%) compared to the non-surgery group (25.4%, p<0.001). In contrast, the number of outpatient prescriptions of UC-related drugs in the non-surgery group (11.2) was almost twice as large as in the surgery group (5.8, p<0.001). Hospitalization cost was 4.6 times higher in the surgery (1955.5€) than in the non-surgery group (419.6€, p<0.001). Medication cost was three times higher in the non-surgery group (6519€) compared to the surgery group (2151.7€, p<0.001).
Based on hospitalizations, outpatient visits, and medical treatment, results show a considerable patient burden in UC from surgery complications or disease exacerbation in case of colectomy.
利用索赔数据评估接受手术和未接受手术的溃疡性结肠炎 (UC) 患者的医疗资源利用 (HCRU) 和成本。
纳入 2010 年 1 月 1 日至 2017 年 12 月 31 日期间参加德国某健康保险的 UC 患者。识别出在 2010 年 7 月 1 日至 2014 年 12 月 31 日期间接受过直肠结肠切除术或结肠切除术的患者，并将手术日期设为索引。对于接受回肠储袋肛管吻合术 (IPAA) 的患者，将最近的手术时间作为索引。未手术的患者则随机选择索引。在进行倾向评分匹配后，观察索引后 3 年 UC 相关 HCRU 和成本。
在 21392 名 UC 患者中，有 85 名接受了手术，2655 名未接受手术。匹配后，手术组纳入 76 例，非手术组纳入 114 例。两组基线特征和死亡率无差异，均较高（分别为 21.1%和 29.0%）。在随访期间，手术组（53.9%）至少有一次住院的患者比例高于非手术组（25.4%，p<0.001）。相比之下，非手术组（11.2）UC 相关药物的门诊处方数量几乎是非手术组的两倍（手术组 5.8，p<0.001）。手术组（1955.5 欧元）的住院费用比非手术组（419.6 欧元）高 4.6 倍（p<0.001）。非手术组（6519 欧元）的药物治疗费用比手术组（2151.7 欧元）高 3 倍（p<0.001）。
基于住院、门诊就诊和医疗治疗情况，结果表明，接受手术的患者可能因手术并发症或结肠切除术后疾病恶化而面临更大的 UC 患者负担，而非手术患者的 UC 相关医疗资源利用和成本与接受手术的患者存在显著差异。
