From the Value Evidence & Outcomes, GSK, Collegeville, PA.
Health Outcomes, Policy, and Economics Program (HOPE), Rutgers University, New Brunswick, NJ.
Pancreas. 2021 Mar 1;50(3):330-340. doi: 10.1097/MPA.0000000000001757.
This retrospective cohort study assessed short- and long-term economic, clinical burden, and productivity impacts of acute pancreatitis (AP) in the United States.
United States claims data from patients hospitalized for AP (January 1, 2011-September-30, 2016) were sourced from MarketScan databases. Patients were categorized by index AP severity: severe intensive care unit (ICU), severe non-ICU, and other hospitalized patients.
During index, 41,946 patients were hospitalized or visited an emergency department for AP. For inpatients, median (interquartile range) AP-related total cost was $13,187 ($12,822) and increased with AP severity (P < 0.0001). During the postindex year, median AP-related costs were higher (P < 0.0001) for severe ICU versus severe non-ICU and other hospitalized patients. Hours lost and costs due to absence and short-term disability were similar between categories. Long-term disability costs were higher (P = 0.005) for severe ICU versus other hospitalized patients. Factors associated with higher total all-cause costs in the year after discharge included AP severity, length of hospitalization, readmission, AP reoccurrence, progression to chronic pancreatitis, or new-onset diabetes (P < 0.0001).
An AP event exerts substantial burden during hospitalization and involves long-term clinical and economic consequences, including loss of productivity, which increase with index AP event severity.
本回顾性队列研究评估了美国急性胰腺炎（AP）的短期和长期经济、临床负担和生产力影响。
美国 2011 年 1 月 1 日至 2016 年 9 月 30 日，从 MarketScan 数据库中获取了因 AP 住院治疗（住院或急诊）患者的美国索赔数据。根据指数 AP 严重程度将患者分为重症加强护理病房（ICU）、非重症 ICU 和其他住院患者。
在指数期，有 41946 名患者因 AP 住院或到急诊就诊。对于住院患者，AP 相关总费用的中位数（四分位距）为 13187 美元（12822 美元），并随 AP 严重程度的增加而增加（P<0.0001）。在指数后一年，重症 ICU 患者的 AP 相关费用中位数均高于重症非 ICU 和其他住院患者（P<0.0001）。因缺勤和短期残疾导致的损失时间和费用在各个类别之间相似。重症 ICU 患者的长期残疾费用高于其他住院患者（P=0.005）。出院后一年总全因费用较高的因素包括 AP 严重程度、住院时间、再入院、AP 复发、进展为慢性胰腺炎或新发糖尿病（P<0.0001）。
AP 事件在住院期间会产生巨大负担，并涉及长期的临床和经济后果，包括生产力的丧失，且这些后果会随指数 AP 事件严重程度的增加而增加。
