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哥伦比亚一家风湿护理中心银屑病关节炎患者的医疗资源利用频率及直接医疗费用

Frequency of Health Care Resource Utilization and Direct Medical Costs Associated with Psoriatic Arthritis in a Rheumatic Care Center in Colombia.

作者信息

Santos-Moreno Pedro, Gómez-De la Rosa Fernando, Parra-Padilla Devian, Alvis-Zakzuk Nelson J, R Alvis-Zakzuk Nelson, Carrasquilla-Sotomayor María, Valencia Omaira, Alvis-Guzmán Nelson

机构信息

Biomab IPS - Center for Rheumatoid Arthritis, Bogotá, Colombia.

Department of Health Technology Assessment, ALZAK Foundation, Cartagena, Colombia.

出版信息

Psoriasis (Auckl). 2021 Mar 18;11:31-39. doi: 10.2147/PTT.S270621. eCollection 2021.

Abstract

OBJECTIVE

To estimate the frequency of health care resource utilization and direct medical costs associated with Psoriatic Arthritis (PsA) in a rheumatic care center in Colombia.

METHODS

A retrospective prevalence-based cost of illness study under the Colombian health care system perspective was conducted. We analyzed the frequency of health care resource utilization and estimated direct medical costs using anonymized medical records of adult patients (≥18 years) diagnosed with PsA at a rheumatology care center in Bogotá, Colombia. Patients were required to have at least one medical visit linked to a PsA diagnosis (ICD-10 L40.5) between October 2018 and October 2019 and a previous diagnose by the CASPAR criteria. Data on hospitalization episodes was not available. Direct medical costs were estimated in Colombian pesos (COP) and reported in US dollars (USD) using an exchange rate of 1USD = 3263.4 COP. A multivariate generalized linear model was used for identifying potential cost predictors.

RESULTS

A sample of 83 patients was obtained. Of these, 54.2% were women and had a mean (SD) age of 58.7 (12) years at baseline. On average, they had 2.2 and 3.8 medical visits to the dermatologist and rheumatologist in the study period. The total direct medical cost was estimated at 410,985 US Dollars. Medical visits, therapies, laboratory and imaging represented 3.2% of total expenses and medications the remaining 96.8%. Patients receiving conventional DMARDs (cDMARDs) had an associated mean cost of 1020.1 USD (CI 701.4-1338.8) in a year. Among patients treated with cDMARDs and biological DMARDs (bDMARDs) the mean cost increase to 8113.9 USD (SD 5182.0-95% CI 6575.1-9652.8).

CONCLUSION

A patient under biological therapy can increase their annual cost by 7.9 times the cost of a patient in conventional therapy. This provided updated knowledge on the direct medical costs, from the provision of a rheumatic care center service, to support epidemiologic or pharmacovigilance models.

摘要

目的

评估哥伦比亚一家风湿科护理中心银屑病关节炎(PsA)患者的医疗资源利用频率及直接医疗费用。

方法

基于哥伦比亚医疗保健系统视角,开展一项回顾性患病率疾病成本研究。我们利用哥伦比亚波哥大一家风湿科护理中心确诊为PsA的成年患者(≥18岁)的匿名医疗记录,分析医疗资源利用频率并估算直接医疗费用。患者需在2018年10月至2019年10月期间至少有一次与PsA诊断(ICD - 10 L40.5)相关的就诊记录,且之前已根据CASPAR标准确诊。住院病历数据不可用。直接医疗费用以哥伦比亚比索(COP)估算,并使用1美元 = 3263.4比索的汇率换算为美元(USD)报告。采用多元广义线性模型识别潜在成本预测因素。

结果

共纳入83例患者样本。其中,54.2%为女性,基线时平均(标准差)年龄为58.7(12)岁。在研究期间,他们平均看皮肤科医生和风湿科医生的次数分别为2.2次和3.8次。直接医疗总费用估计为410,985美元。就诊、治疗、实验室检查和影像学检查占总费用的3.2%,药物占其余的96.8%。接受传统改善病情抗风湿药(cDMARDs)治疗的患者每年平均费用为1020.1美元(置信区间701.4 - 1338.8)。在接受cDMARDs和生物制剂改善病情抗风湿药(bDMARDs)治疗的患者中,平均费用增至8113.9美元(标准差5182.0 - 95%置信区间6575.1 - 9652.8)。

结论

接受生物治疗的患者每年费用可能比接受传统治疗的患者增加7.9倍。这为从风湿科护理中心服务提供方面了解直接医疗费用提供了最新知识,以支持流行病学或药物警戒模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1519/7987305/40e6da42a6f4/PTT-11-31-g0001.jpg

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