Janssen Pharmaceutica NV, Beerse, Belgium.
Janssen Vaccines & Prevention BV, Leiden, the Netherlands.
J Manag Care Spec Pharm. 2023 Aug;29(8):873-883. doi: 10.18553/jmcp.2023.29.8.873.
Although invasive disease (IED) can lead to severe clinical outcomes, little is known about the associated medical resource use and cost burden of IED in US hospitals. To comprehensively describe medical resource use and costs associated with IED during the initial IED event and over the subsequent 12 months. Patients aged 60 years or older with 1 or more IED encounters were identified from the PINC AI Healthcare US hospital database (October 1, 2015, to March 31, 2020). The index encounter was defined as the first encounter with a positive coli culture in a normally sterile site (group 1 IED) or positive culture in urine with signs of sepsis (group 2 IED). Encounters with a positive culture from other bacteria or fungal pathogens were excluded. Outcomes were descriptively reported between admission and discharge for the index encounter and more than 1 - year post-index discharge. Medical resource use and costs included inpatient admissions and outpatient hospital services; costs were reported from a hospital's perspective (ie, charged amount) in 2021 USD. A total of 19,773 patients were identified (group 1 IED = 51.8%; group 2 IED = 48.2%). Mean age was 76.8 years, 67.4% were female, and 82.1% were White. Most index encounters were community-onset (94.3%) and led to hospitalization (96.5%) (mean inpatient days = 6.9 days). During the 1 - year post-index, 36.8% of patients had 1 or more all-cause hospitalizations. Mean [median] total all-cause hospital costs (as captured through the PINC AI Healthcare database) amounted to $16,760 [$11,340] during the index encounter and $10,942 [$804] during the 1 - year post-index; these costs were higher in the presence of sepsis and multidrug resistance and among hospital-onset IED. IED is associated with a substantial medical resource use and economic burden both during the initial encounter and over the following year in older adults. This highlights the critical need and potential benefits of preventive measures that may reduce the incidence of IED and associated economic burden. This study was funded by Janssen Global Services, LLC. Dr Hernandez-Pastor is an employee of Janssen Pharmaceutica NV. Dr Geurtsen is an employee of Janssen Vaccines & Prevention BV. Dr Baugh is an employee of Janssen Research & Development, LLC. Dr El Khoury is an employee of Janssen Global Services, LLC. Dr Kalu and Dr Krishnarajah are employees of Janssen Scientific Affairs, LLC. Dr Gauthier-Loiselle, Ms Bungay, and Mr Cloutier are employees of Analysis Group, Inc., a consulting company that provided paid consulting services to Janssen Global Services, LLC. Dr Saade received consultation and speaker fees from Janssen.
尽管侵袭性疾病 (IED) 可能导致严重的临床后果,但在美国医院中,与 IED 相关的医疗资源使用和成本负担知之甚少。本研究旨在全面描述与初始 IED 事件及随后 12 个月内的 IED 相关的医疗资源使用和成本。从 PINC AI Healthcare 美国医院数据库中(2015 年 10 月 1 日至 2020 年 3 月 31 日)确定了年龄在 60 岁及以上且有 1 次或多次 IED 就诊的患者。索引就诊被定义为首次在正常无菌部位出现阳性 coli 培养物(组 1 IED)或尿液中出现阳性 培养物且伴有败血症迹象(组 2 IED)。排除了其他细菌或真菌病原体的阳性培养物。在索引就诊期间的入院至出院以及索引出院后 1 年以上,对结果进行描述性报告。医疗资源使用和成本包括住院和门诊医院服务;以医院为视角(即收费金额)报告了 2021 年美元的成本。共确定了 19773 例患者(组 1 IED = 51.8%;组 2 IED = 48.2%)。平均年龄为 76.8 岁,67.4%为女性,82.1%为白人。大多数索引就诊为社区发病(94.3%)并导致住院治疗(96.5%)(平均住院天数=6.9 天)。在索引后 1 年内,36.8%的患者有 1 次或多次全因住院治疗。索引就诊期间的全因总医院费用(通过 PINC AI Healthcare 数据库捕获)平均为 16760 美元[中位数为 11340 美元],索引后 1 年内为 10942 美元[中位数为 804 美元];在存在败血症和多药耐药性以及医院发病的 IED 时,这些费用更高。IED 在老年人中不仅在初始就诊期间,而且在随后的 1 年内都会导致大量的医疗资源使用和经济负担。这突出表明,迫切需要并可能受益于预防措施,以降低 IED 的发生率和相关的经济负担。本研究由杨森全球服务公司资助。Hernandez-Pastor 博士是杨森制药公司的员工。Geurtsen 博士是杨森疫苗与预防公司的员工。Baugh 博士是杨森研发公司的员工。El Khoury 博士是杨森全球服务公司的员工。Kalu 博士和 Krishnarajah 博士是杨森科学事务公司的员工。Gauthier-Loiselle 博士、Bungay 女士和 Cloutier 先生是 Analysis Group,Inc.的员工,该公司是一家为杨森全球服务公司提供付费咨询服务的咨询公司。Saade 博士从杨森获得咨询和演讲费。