Axon David R, Marupuru Srujitha, Vaffis Shannon
College of Pharmacy, The University of Arizona, Tucson, AZ 85721, USA.
Diseases. 2021 Jun 10;9(2):41. doi: 10.3390/diseases9020041.
This retrospective cross-sectional database study used 2018 Medical Expenditure Panel Survey data to quantify and assess differences in healthcare expenditures between opioid users and non-users among a non-institutionalized sample of older (≥50 years) United States adults with pain in the past four weeks and a diagnosis of comorbid hypercholesterolemia (pain-hypercholesterolemia group) or hypertension (pain-hypertension group). Hierarchical multivariable linear regression models were constructed by using logarithmically transformed positive cost data and adjusting for relevant factors to assess cost differences between groups. Percent difference between opioid users and non-users was calculated by using semi-logarithmic equations. Healthcare costs included inpatient, outpatient, office-based, emergency room, prescription medication, other, and total costs. In adjusted analyses, compared to non-users, opioid users in the pain-hypercholesterolemia and pain-hypertension groups respectively had 66% and 60% greater inpatient expenditure, 46% and 55% greater outpatient expenditure, 67% and 72% greater office-based expenditure, 50% and 60% greater prescription medication expenditure, 24% and 22% greater other healthcare expenditure, and 85% and 93% greater total healthcare expenditure. In conclusion, adjusted total healthcare expenditures were 85-93% greater among opioid users versus non-users in older United States adults with pain and comorbid hypercholesterolemia or hypertension. Future research is needed to identify opioid use predictors among these populations and reduce expenditures.
这项回顾性横断面数据库研究使用了2018年医疗支出面板调查数据，以量化和评估在过去四周内有疼痛且被诊断患有合并高胆固醇血症（疼痛-高胆固醇血症组）或高血压（疼痛-高血压组）的50岁及以上非机构化美国成年人样本中，阿片类药物使用者和非使用者之间的医疗保健支出差异。通过使用对数转换后的正向成本数据并对相关因素进行调整，构建分层多变量线性回归模型，以评估组间成本差异。使用半对数方程计算阿片类药物使用者和非使用者之间的百分比差异。医疗保健成本包括住院、门诊、基于办公室的、急诊室、处方药、其他以及总成本。在调整分析中，与非使用者相比，疼痛-高胆固醇血症组和疼痛-高血压组中的阿片类药物使用者的住院支出分别高出66%和60%，门诊支出分别高出46%和55%，基于办公室的支出分别高出67%和72%，处方药支出分别高出50%和60%，其他医疗保健支出分别高出24%和22%，总医疗保健支出分别高出85%和93%。总之，在美国患有疼痛且合并高胆固醇血症或高血压的老年成年人中，阿片类药物使用者的调整后总医疗保健支出比非使用者高出85%-93%。需要进一步研究以确定这些人群中阿片类药物使用的预测因素并降低支出。
