Department of Urology, Albany Medical College, 23 Hackett Blvd, Albany, NY, 12208, USA.
NociSci, Inc, Durham, NC, USA.
Int Urol Nephrol. 2022 Nov;54(11):2797-2803. doi: 10.1007/s11255-022-03296-0. Epub 2022 Jul 29.
With the ubiquity of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH) in older men, costs related to this highly prevalent disease are likely significant but not well defined. With this study, we hoped to define costs related to LUTS/BPH care.
We utilized the Optum de-identified Clinformatics® Data Mart Database (CDM) for privately insured male enrollees aged 40-64 years with LUTS/BPH (N ≈ 100,300 annually) and the Centers for Medicare and Medicaid Services Medicare 5% Sample for male beneficiaries aged 65 + years with LUTS/BPH (N ≈ 147,800 annually). Annual LUTS/BPH-related expenditures from 2004 to 2013 were age standardized and calculated overall and by age and service location.
The Medicare cohort demonstrated a 23% increase in total costs over the study period with a 28% decrease in CDM costs. Decreases in inpatient hospital charges (45% for Medicare, 55% for CDM) were offset by increasing hospital-based outpatient fees (120% for Medicare, 87% for CDM). Overall, we estimated a total cost of at least $1.9 billion for treatment of men with LUTS/BPH for 2013. Per person expenditures increased with age within cohorts with an average per-person cost of $269 (CDM) and $248 (Medicare) in 2013.
The distribution of healthcare expenditures for LUTS/BPH shifted across practice settings from 2004 to 2013, with increasing outpatient relative to inpatient expenditures. Total direct costs for LUTS/BPH in 2013 were at least $1.9 billion, not accounting for indirect costs or certain unmeasured populations.
由于良性前列腺增生（BPH）导致的下尿路症状（LUTS）在老年男性中普遍存在，因此与这种高发疾病相关的成本很可能很高，但尚未得到明确界定。本研究旨在确定与 LUTS/BPH 治疗相关的成本。
我们利用 Optum 去识别 Clinformatics® Data Mart 数据库（CDM）中 40-64 岁患有 LUTS/BPH 的男性参保者（每年约 100,300 人）和医疗保险和医疗补助服务中心 Medicare 5%抽样男性受益人的数据（每年约 147,800 人）。根据年龄对 2004 年至 2013 年的年度 LUTS/BPH 相关支出进行标准化，并按年龄和服务地点进行总体和分类计算。
在研究期间，Medicare 队列的总费用增加了 23%，而 CDM 的费用减少了 28%。住院医院收费的减少（Medicare 为 45%，CDM 为 55%）被增加的医院门诊费用所抵消（Medicare 为 120%，CDM 为 87%）。总的来说，我们估计 2013 年至少有 19 亿美元用于治疗患有 LUTS/BPH 的男性。在队列内，随着年龄的增长，每个人的支出都在增加，2013 年每个人的平均支出为 269 美元（CDM）和 248 美元（Medicare）。
2004 年至 2013 年，LUTS/BPH 的医疗支出分布在各医疗场所发生了变化，门诊支出相对于住院支出有所增加。2013 年，LUTS/BPH 的直接总成本至少为 19 亿美元，未考虑间接成本或某些未测量人群。
