Rasendran Chandruganesh, Li Ang, Singh Rishi P
Department of Ophthalmology and Visual Sciences, University Hospitals Eye Institute and the Case Western Reserve.
Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH.
J Glaucoma. 2022 Jan 1;31(1):1-7. doi: 10.1097/IJG.0000000000001957.
Adjusting for sociodemographics and comorbidities, patients with glaucoma incur an annual incremental economic burden of $1863.17, translating to $9.2 billion nationally. When analyzed by the health care service sector, prescription medication expenditures were higher for glaucoma patients.
The purpose of this study was to estimate the incremental health care burden, defined as attributable costs solely due to a diagnosis, of patients with diagnosed glaucoma, controlling for comorbidities, and sociodemographics.
A retrospective cross-sectional analysis of Medical Expenditure Panel Survey (MEPS) participants (age above 18 y) between 2016 and 2018.
A cross-validated 2-part generalized linear regression model estimated the incremental glaucoma expenditures in aggregate and by sociodemographic subgroups and health care service sector [inpatient, outpatient (including surgical procedures), emergency room, home health, and medications] after 1:3 propensity matching.
After 1:3 propensity matching for sociodemographics and the Charlson Comorbidity Index, this study analyzed 1521 glaucoma patients (mean expenditures: $13,585.68±1367.03) and 4563 patients without glaucoma (mean expenditures: $12,048.92±782.49). A higher proportion of glaucoma patients are female, elderly, publicly insured (Medicare/Medicaid), college educated, identify ethnically as non-Hispanic, reside in the Northeast, and have more comorbidities (P<0.001). There were no differences in health care burden based on sex, income, insurance status, education, and year of care received for patients with glaucoma. Controlling for comorbidities and socioeconomic factors, propensity-matched glaucoma patients incur an annual incremental health care burden of $1863.17 (95% confidence interval, 393.44-3117.23, P=0.013), translating into an additional $9.2 billion in population-level US health care expenditures. By health care service sector, the expenditure ratio for health care expenditures was higher for prescription medications (expenditure ratio=1.20, 95% confidence interval, 1.02-1.42, P=0.031).
Glaucoma patients have a substantial incremental economic health care burden after accounting for demographics and comorbidities, largely secondary to prescription medications. There is a need to continue identifying and studying treatment options for patients with glaucoma to maintain vision while minimizing health care expenditures.
在对社会人口统计学和合并症进行调整后，青光眼患者每年的额外经济负担为1863.17美元，全国范围内总计92亿美元。按医疗服务部门分析，青光眼患者的处方药支出更高。
本研究的目的是估计已确诊青光眼患者在控制合并症和社会人口统计学因素后的额外医疗负担，即仅因诊断而产生的可归因成本。
对2016年至2018年医疗支出面板调查（MEPS）参与者（年龄在18岁以上）进行回顾性横断面分析。
采用交叉验证的两部分广义线性回归模型，在1:3倾向匹配后，估计青光眼的总体额外支出以及按社会人口统计学亚组和医疗服务部门[住院、门诊（包括外科手术）、急诊室、家庭医疗和药物]划分的额外支出。
在对社会人口统计学和查尔森合并症指数进行1:3倾向匹配后，本研究分析了1521例青光眼患者（平均支出：13585.68±1367.03美元）和4563例非青光眼患者（平均支出：12048.92±782.49美元）。青光眼患者中女性、老年人、公共保险（医疗保险/医疗补助）、受过大学教育、非西班牙裔、居住在东北部且合并症更多的比例更高（P<0.001）。青光眼患者的医疗负担在性别、收入、保险状况、教育程度和接受治疗年份方面没有差异。在控制合并症和社会经济因素后，倾向匹配的青光眼患者每年的额外医疗负担为1863.17美元（95%置信区间，393.44 - 3117.23，P = 0.013），这意味着美国医疗保健支出在人口层面上额外增加92亿美元。按医疗服务部门划分，处方药的医疗保健支出比例更高（支出比例 = 1.20，95%置信区间，1.02 - 1.42，P = 0.031）。
在考虑人口统计学和合并症后，青光眼患者有相当大的额外经济医疗负担，主要归因于处方药。有必要继续识别和研究青光眼患者的治疗方案，以维持视力同时尽量减少医疗保健支出。
