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2010-2018 年美国癫痫患者医疗保健支出的驱动因素。

Drivers of US health care spending for persons with seizures and/or epilepsies, 2010-2018.

机构信息

Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.

Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Epilepsia. 2022 Aug;63(8):2144-2154. doi: 10.1111/epi.17305. Epub 2022 May 29.

Abstract

OBJECTIVE

This study was undertaken to characterize spending for persons classified with seizure or epilepsy and to determine whether spending has increased over time.

METHODS

In this cross-sectional study, we pooled data from the Medical Expenditure Panel Survey (MEPS) household component files for 2010-2018. We matched cases to controls on age and sex of a population-based sample of MEPS respondents (community-dwelling persons of all ages) with records associated with a medical event (e.g., outpatient visit, hospital inpatient) for seizure, epilepsy, or both. Outcomes were weighted to be representative of the civilian, noninstitutionalized population. We estimated the treated prevalence of epilepsy and seizure, health care spending overall and by site of care, and trends in spending growth.

RESULTS

We identified 1078 epilepsy cases and 2344 seizure cases. Treated prevalence was .38% (95% confidence interval [CI] = .34-.41) for epilepsy, .76% (95% CI = .71-.81) for seizure, and 1.14% (95% CI = 1.08-1.20) for epilepsy or seizure. The difference in annual spending for cases compared to controls was $4580 (95% CI = $3362-$5798) for epilepsy, $7935 (95% CI, $6237-$9634) for seizure, and $6853 (95% CI = $5623-$8084) for epilepsy or seizure, translating into aggregate costs of $5.4 billion, $19.0 billion, and $24.5 billion. From 2010 to 2018, the annual growth rate in total spending incurred for seizures and/or epilepsies was 7.6% compared to 3.6% among controls.

SIGNIFICANCE

US economic burden of seizures and/or epilepsies is substantial and warrants interventions focused on their unique and overlapping causes.

摘要

目的

本研究旨在描述癫痫患者的支出特征,并确定其支出是否随时间而增加。

方法

在这项横断面研究中,我们汇集了 2010 年至 2018 年期间医疗支出面板调查(MEPS)家庭部分文件的数据。我们将病例与对照进行匹配,对照为 MEPS 受访者(所有年龄段的社区居住者)的人口基础样本的年龄和性别,这些受访者的记录与癫痫、癫痫发作或两者相关的医疗事件(如门诊就诊、住院患者)相关。结果进行了加权处理,以代表平民非住院人群。我们估计了癫痫和癫痫发作的治疗患病率、总体医疗保健支出以及按护理地点划分的支出以及支出增长趋势。

结果

我们确定了 1078 例癫痫病例和 2344 例癫痫发作病例。癫痫的治疗患病率为 0.38%(95%置信区间 [CI] = 0.34-.41),癫痫发作的治疗患病率为 0.76%(95% CI = 0.71-.81),癫痫或癫痫发作的治疗患病率为 1.14%(95% CI = 1.08-1.20)。与对照相比,病例的年支出差异为癫痫病例为 4580 美元(95% CI = 3362-5798),癫痫发作病例为 7935 美元(95% CI,6237-9634),癫痫或癫痫发作病例为 6853 美元(95% CI = 5623-8084),总费用为 54 亿美元,190 亿美元和 245 亿美元。从 2010 年到 2018 年,癫痫和/或癫痫发作的总支出年增长率为 7.6%,而对照组为 3.6%。

意义

美国癫痫发作和/或癫痫的经济负担很大,需要针对其独特和重叠的原因进行干预。

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