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尿失禁对美国支付者的医疗资源利用和费用负担。

Healthcare resource use and cost burden of urinary incontinence to United States payers.

机构信息

Boston Healthcare Associates, Inc., Boston, Massachusetts, USA.

Renovia, Inc., Boston, Massachusetts, USA.

出版信息

Neurourol Urodyn. 2022 Sep;41(7):1553-1562. doi: 10.1002/nau.24989. Epub 2022 Jun 16.

Abstract

OBJECTIVE

To assess healthcare resource utilization and costs for female patients diagnosed with stress or mixed urinary incontinence (SUI/MUI) compared to a matched cohort of patients without SUI/MUI.

METHODS

We conducted a retrospective matched cohort study of women using the IBM MarketScan research database. Women diagnosed with SUI/MUI between July 1, 2014 and June 30, 2016 were identified using International Classification of Diseases 9 and 10 codes for SUI or MUI with the date of first diagnosis as the index date from which 2-year postindex healthcare resource use and direct cost data were derived from claims, examined, and compared 1:1 with patients without a SUI/MUI diagnosis, matched by age and Charlson's Comorbidity Index.

RESULTS

A total of 68 636 women with SUI/MUI were matched 1:1 with controls. In the 2-year postindex date, a significantly higher proportion of SUI/MUI patients had ≥1 inpatient visit and ≥1 outpatient visit compared to the control group (inpatient: 18.89% vs. 12.10%, p < 0.0001; outpatient: 88.44% vs. 73.23%, p < 0.0001). Mean primary care visits were significantly higher in SUI/MUI patients compared to controls (7.33 vs. 5.53; p < 0.0001) as were specialist visits (1.2 vs. 0.08; p < 0.0001). Mean all-cause outpatient costs were higher in SUI/MUI patients compared to controls ($7032.10 vs. $3348.50; p < 0.0001), as were inpatient costs ($3990.70 vs. $2313.70; p < 0.0001).

CONCLUSION

Women with SUI/MUI consume significantly higher medical resources and incur higher costs to payers, compared to women without SUI/MUI. While reasons for this are not fully understood, improved and standardized treatment for women with SUI/MUI may positively affect cost and outcomes.

摘要

目的

评估与未患压力性或混合性尿失禁(SUI/MUI)的匹配队列相比,诊断为 SUI/MUI 的女性患者的医疗资源利用和成本。

方法

我们使用 IBM MarketScan 研究数据库进行了一项回顾性匹配队列研究。使用国际疾病分类第 9 版和第 10 版的 SUI 或 MUI 代码,确定 2014 年 7 月 1 日至 2016 年 6 月 30 日期间诊断为 SUI/MUI 的女性患者,并将首次诊断日期作为索引日期,从索赔中提取索引日期后 2 年的医疗资源使用和直接成本数据,并与未诊断为 SUI/MUI 的患者 1:1 进行比较,这些患者通过年龄和 Charlson 合并症指数进行匹配。

结果

共有 68636 名 SUI/MUI 女性患者与对照组进行了 1:1 匹配。在索引日期后 2 年,SUI/MUI 患者的住院和门诊就诊比例明显高于对照组(住院:18.89%比 12.10%,p<0.0001;门诊:88.44%比 73.23%,p<0.0001)。与对照组相比,SUI/MUI 患者的初级保健就诊次数明显较高(7.33 次比 5.53 次;p<0.0001),专科就诊次数也较高(1.2 次比 0.08 次;p<0.0001)。SUI/MUI 患者的全因门诊费用高于对照组(7032.10 美元比 3348.50 美元;p<0.0001),住院费用也高于对照组(3990.70 美元比 2313.70 美元;p<0.0001)。

结论

与未患 SUI/MUI 的女性相比,SUI/MUI 女性患者消耗的医疗资源明显更多,给支付方带来的成本也更高。尽管原因尚不完全清楚,但对 SUI/MUI 女性患者进行更好和更标准化的治疗可能会对成本和结果产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8b2/9542745/7cf19146cd98/NAU-41-1553-g002.jpg

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