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儿童期牛奶过敏的健康经济影响:一项回顾性队列研究。

The health economic impact of cow's milk allergy in childhood: A retrospective cohort study.

作者信息

Cawood Abbie L, Meyer R, Grimshaw Kate E, Sorensen Katy, Acosta-Mena Dionisio, Stratton Rebecca J

机构信息

Institute of Human Nutrition, Faculty of Medicine, Southampton General Hospital, Southampton, UK.

Medical Affairs, Nutricia Ltd, White Horse Business Park, Trowbridge, UK.

出版信息

Clin Transl Allergy. 2022 Aug;12(8):e12187. doi: 10.1002/clt2.12187.

Abstract

BACKGROUND

Cow's milk allergy (CMA) is one of the most common food allergies among children. Whilst avoidance of cow's milk protein is the cornerstone of management, further treatment of symptoms including those affecting the gastrointestinal, skin and respiratory systems plus other allergic comorbidities, maybe required. This study aimed to quantify the wider economic impact of CMA and its management in the United Kingdom (UK).

METHODS

We conducted a retrospective matched cohort study on children with CMA (diagnosis read code and/or hypoallergenic formula prescription for ≥3 months) examining healthcare data (medication prescriptions and healthcare professional contacts) from case records within The Health Improvement Network (A Cegedim Proprietary Database) in the UK. A comparative cost analysis was calculated based on healthcare tariff and unit costs in the UK.

RESULTS

6998 children (54% male; mean observation period 4.2 years) were included (n = 3499 with CMA, mean age at diagnosis 4.04 months; n = 3499 matched controls without CMA). Compared to those without CMA, medications were prescribed to significantly more children with CMA (p < 0.001) at a higher rate (p < 0.001). Children with CMA also required significantly more healthcare contacts (p < 0.001) at higher rate (p < 0.001) compared to those without CMA. CMA was associated with additional potential healthcare costs of £1381.53 per person per year.

CONCLUSION

The findings of this large cohort study suggest that CMA and its associated co-morbidities presents a significant additional healthcare burden with economic impact due to higher prescribing of additional medications. Further research into management approaches that may impact these clinical and economic outcomes of CMA is warranted.

摘要

背景

牛奶过敏(CMA)是儿童中最常见的食物过敏之一。虽然避免摄入牛奶蛋白是管理的基石,但可能需要进一步治疗包括影响胃肠道、皮肤和呼吸系统的症状以及其他过敏合并症。本研究旨在量化CMA及其管理在英国的更广泛经济影响。

方法

我们对患有CMA的儿童(诊断读取代码和/或低敏配方奶粉处方≥3个月)进行了一项回顾性匹配队列研究,研究英国健康改善网络(一个Cegedim专有数据库)病例记录中的医疗数据(药物处方和医疗专业人员接触情况)。基于英国的医疗收费标准和单位成本进行了比较成本分析。

结果

纳入了6998名儿童(54%为男性;平均观察期4.2年)(n = 3499名患有CMA,诊断时平均年龄4.04个月;n = 3499名匹配的无CMA对照)。与无CMA的儿童相比,患有CMA的儿童服用药物的比例显著更高(p < 0.001),且开药的儿童数量也显著更多(p < 0.001)。与无CMA的儿童相比,患有CMA的儿童还需要更高频率的医疗接触(p < 0.001),且接触次数显著更多(p < 0.001)。CMA与每人每年额外的潜在医疗费用1381.53英镑相关。

结论

这项大型队列研究的结果表明,CMA及其相关合并症由于额外药物的更高处方率,带来了显著的额外医疗负担和经济影响。有必要进一步研究可能影响CMA这些临床和经济结果的管理方法。

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