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与糖尿病性和特发性胃轻瘫相关的医疗资源使用和成本:胃轻瘫诊断后 3 年内的索赔分析。

Health-care resource use and costs associated with diabetic and idiopathic gastroparesis: A claims analysis of the first 3 years following the diagnosis of gastroparesis.

机构信息

Takeda Development Center Americas, Inc., Cambridge, Massachusetts, USA.

Analysis Group, Inc., Boston, Massachusetts, USA.

出版信息

Neurogastroenterol Motil. 2022 Sep;34(9):e14366. doi: 10.1111/nmo.14366. Epub 2022 Mar 30.

Abstract

BACKGROUND

Due to limited treatment options, many patients with diabetic gastroparesis (DG) or idiopathic gastroparesis (IG) experience inadequate symptom control resulting in increased health-care resource utilization (HRU) and associated costs. We compared all-cause HRU and health-care costs over the 3 years after patients' first gastroparesis diagnosis with that of matched controls without gastroparesis.

METHODS

Newly diagnosed adults with DG or IG were identified in Optum's de-identified Clinformatics Data Mart Database (Q1-2007 to Q1-2019). Patients with DG/IG were matched 1:1 to controls using a mixed approach of exact matching and propensity score matching. The index date was the first gastroparesis diagnosis for cases or randomly selected for controls. All-cause HRU and direct health-care costs per person-year (PPY) were compared between DG/IG cases and controls in Years 1-3 post-index.

KEY RESULTS

Demographics and comorbidities were balanced between patients with gastroparesis (n = 18,015 [DG]; n = 14,305 [IG]) and controls. In each of the Years 1-3 post-index, patients with DG or IG had significantly higher annual HRU and costs versus controls (mean total cost differences PPY: DG Year 1 $34,885, Year 2 $28,071, Year 3 $25,606; IG Year 1 $23,176, Year 2 $16,627, Year 3 $14,396) (all p < 0.05). Across all 3 years, DG/IG cohorts had approximately twice the costs of controls. HRU and costs were highest in Year 1 post-index for both DG and IG.

CONCLUSIONS & INFERENCES: The economic burden of gastroparesis remains high several years after diagnosis, emphasizing the need for chronic treatment to effectively manage symptoms and consequently reduce the burden of this disorder.

摘要

背景

由于治疗选择有限,许多糖尿病性胃轻瘫(DG)或特发性胃轻瘫(IG)患者的症状控制不足,导致医疗资源利用(HRU)增加和相关成本增加。我们比较了患者首次胃轻瘫诊断后 3 年内的全因 HRU 和医疗保健费用与无胃轻瘫的匹配对照。

方法

在 Optum 的去识别 Clinformatics Data Mart 数据库(2007 年第一季度至 2019 年第一季度)中确定了新诊断的 DG 或 IG 成年患者。使用精确匹配和倾向评分匹配的混合方法对 DG/IG 患者进行 1:1 与对照匹配。索引日期为病例的首次胃轻瘫诊断日期或对照的随机选择日期。在索引后第 1-3 年,比较 DG/IG 病例和对照的全因 HRU 和人均每年(PPY)直接医疗保健费用。

主要结果

在胃轻瘫患者(n=18015[DG];n=14305[IG])和对照之间,人口统计学和合并症得到了平衡。在索引后第 1-3 年的每一年,DG 或 IG 患者的年度 HRU 和费用均明显高于对照组(每年总费用差异 PPY:DG 年 1 为 34885 美元,年 2 为 28071 美元,年 3 为 25606 美元;IG 年 1 为 23176 美元,年 2 为 16627 美元,年 3 为 14396 美元)(均 P<0.05)。在所有 3 年中,DG/IG 队列的费用约为对照组的两倍。对于 DG 和 IG,在索引后第 1 年,HRU 和费用最高。

结论和推论

胃轻瘫的经济负担在诊断后几年仍很高,这强调了需要进行慢性治疗以有效控制症状,从而减轻这种疾病的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2777/9539633/cf8ff1d857a9/NMO-34-e14366-g002.jpg

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