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重症肌无力的医疗资源使用情况:一项美国医保理赔分析。

Healthcare resource use in myasthenia gravis: a US health claims analysis.

作者信息

Mahic Milada, Bozorg Ali, Rudnik Jan, Zaremba Piotr, Scowcroft Anna

机构信息

UCB Pharma, Slough, UK.

UCB Pharma, Morrisville, NC, USA.

出版信息

Ther Adv Neurol Disord. 2023 Jan 24;16:17562864221150327. doi: 10.1177/17562864221150327. eCollection 2023.

Abstract

BACKGROUND

There are limited data on the impact of myasthenia gravis (MG) on real-world healthcare resource use (HCRU) and patient burden in the United States.

OBJECTIVES

This study aims to assess HCRU in patients with MG using data from a US health claims database.

DESIGN

A retrospective, database study of adult patients newly diagnosed with MG, using the IBM MarketScan Commercial Claims and Encounters and Medicare supplemental health insurance claims database.

METHODS

Patients with ⩾2 MG International Classification of Disease diagnosis codes ⩾3 months apart were followed from the date of their first MG diagnosis record or start of treatment. HCRU and use of immunoglobulins and plasma exchange during follow-up was assessed, as well as comorbidities, hospitalizations, emergency room (ER) visits, intensive care unit (ICU) admissions, and specialist visits per year after diagnosis, and compared with age- and sex-matched non-MG controls.

RESULTS

During 2010-2019, 7194 patients were followed for up to 10 years (median = 2.3 years). During follow-up, patients with MG were 2.6-fold more likely than controls to be hospitalized, and 4.5-fold more likely to be admitted to an ICU. Risk and numbers of ER admission, hospitalization, and ICU visits were the highest in the 12 months post-diagnosis of MG and were consistently higher than controls during follow-up. MG was the main cause for most hospitalizations.

CONCLUSION

Patients with MG have higher HCRU, compared with the age- and sex-matched non-MG controls. The early years after MG diagnosis are a period of particularly high healthcare burden, with many patients requiring hospitalization and ICU care to manage serious exacerbations.

摘要

背景

关于重症肌无力(MG)对美国实际医疗资源使用(HCRU)和患者负担的影响,相关数据有限。

目的

本研究旨在利用美国健康保险理赔数据库的数据,评估MG患者的医疗资源使用情况。

设计

一项回顾性数据库研究,针对新诊断为MG的成年患者,使用IBM MarketScan商业保险理赔和医疗记录数据库以及医疗保险补充健康保险理赔数据库。

方法

从首次MG诊断记录日期或开始治疗起,对间隔至少3个月有≥2个MG国际疾病分类诊断代码的患者进行随访。评估随访期间的医疗资源使用情况、免疫球蛋白和血浆置换的使用情况,以及诊断后每年的合并症、住院情况、急诊室(ER)就诊、重症监护病房(ICU)入院和专科就诊情况,并与年龄和性别匹配的非MG对照组进行比较。

结果

在2010 - 2019年期间,对7194例患者进行了长达10年的随访(中位数 = 2.3年)。随访期间,MG患者住院的可能性是对照组的2.6倍,入住ICU的可能性是对照组的4.5倍。急诊入院、住院和ICU就诊的风险及次数在MG诊断后的12个月内最高,且在随访期间一直高于对照组。MG是大多数住院的主要原因。

结论

与年龄和性别匹配的非MG对照组相比,MG患者的医疗资源使用更高。MG诊断后的最初几年是医疗负担特别高的时期,许多患者需要住院和ICU护理来处理严重病情加重情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af5e/9880582/a4c6b6e5cc1d/10.1177_17562864221150327-fig1.jpg

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