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美国囊性纤维化患儿的医疗资源利用情况及费用

Healthcare resource utilization and costs among children with cystic fibrosis in the United States.

作者信息

Thorat Teja, McGarry Lisa J, Bonafede Machaon M, Limone Brendan L, Rubin Jaime L, Jariwala-Parikh Krutika, Konstan Michael W

机构信息

Vertex Pharmaceuticals Incorporated, Boston, Massachusetts, USA.

Veradigm Life Sciences, an Allscripts Healthcare LLC, Chicago, Illinois, USA.

出版信息

Pediatr Pulmonol. 2021 Sep;56(9):2833-2844. doi: 10.1002/ppul.25535. Epub 2021 Jul 7.

Abstract

BACKGROUND

Adverse health impacts of cystic fibrosis (CF) can be present in children before respiratory complications are observed. Children with CF show progressive health decline, with increasing lung function decline in adolescence. This study aims to quantify the healthcare resource utilization (HCRU) and costs attributable to CF by comparing children with CF with the general pediatric population.

METHODS

This retrospective, cross-sectional, observational study compared HCRU and costs among children with CF in the US with demographically similar children without CF (comparison group) over a 12-month period using administrative claims data spanning 2010-2017. Analyses were conducted by insurance type (commercially insured [COM] and Medicaid insured [MED]) and stratified by age (<2 years, 2 to <6 years, 6 to <12 years, and 12-17 years).

RESULTS

Children with CF (2831 COM and 1896 MED) were matched to children in the comparison group (8493 COM and 5688 MED). Higher prevalence of comorbidities was seen in children with CF versus the comparison group across all ages. Across all ages, HCRU attributable to CF was substantial (higher hospitalization rates, more outpatient and emergency room visits, and greater use of prescription medications), and there were higher associated costs (all p values < .05), in COM and MED populations. HCRU and costs attributable to CF were highest for children aged 12-17 years.

CONCLUSIONS

Substantial HCRU and costs are evident among children with CF across all ages, starting as young as infancy, with highest HCRU and costs among adolescents. Effective treatments from an early age are needed for children with CF.

摘要

背景

囊性纤维化(CF)对健康的不良影响在儿童出现呼吸道并发症之前就可能存在。患有CF的儿童健康状况呈渐进性下降,青春期肺功能下降加剧。本研究旨在通过比较患有CF的儿童与一般儿科人群,量化CF所致的医疗资源利用(HCRU)和成本。

方法

这项回顾性、横断面观察性研究使用2010 - 2017年的行政索赔数据,比较了美国患有CF的儿童与人口统计学特征相似的无CF儿童(对照组)在12个月期间的HCRU和成本。分析按保险类型(商业保险[COM]和医疗补助保险[MED])进行,并按年龄分层(<2岁、2至<6岁、6至<12岁和12 - 17岁)。

结果

患有CF的儿童(2831名COM和1896名MED)与对照组儿童(8493名COM和5688名MED)进行了匹配。在所有年龄段,CF患儿的合并症患病率均高于对照组。在所有年龄段,COM和MED人群中CF所致的HCRU都很高(住院率更高、门诊和急诊就诊次数更多、处方药使用量更大),且相关成本更高(所有p值<0.05)。CF所致的HCRU和成本在12 - 17岁儿童中最高。

结论

各年龄段的CF患儿都存在明显的高HCRU和成本,从婴儿期就开始,青少年的HCRU和成本最高。CF患儿需要从幼年开始进行有效治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e5/8456795/2831a5977371/PPUL-56-2833-g003.jpg

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