Urology Partners of North Texas, Arlington, TX.
Boston Scientific, Marlborough, MA.
Urology. 2024 Jul;189:112-118. doi: 10.1016/j.urology.2024.04.018. Epub 2024 Apr 26.
To quantify the incremental downstream revenue generated from subsequent treatment of men who received an inflatable penile prosthesis (IPP) to treat erectile dysfunction (ED), compared to men without ED.
The 100% Medicare Standard Analytic Files were used to conduct a retrospective claims analysis of the 5-year revenue generated by patients receiving IPP to treat their ED, compared to a propensity-matched cohort of men without ED. Men aged 65 years or older with ED who underwent IPP implantation (Current Procedural Terminology 54405) in a hospital outpatient setting between January 1, 2016 and December 31, 2021, and who had continuous Medicare Parts A and B enrollment for 12 months pre-index IPP and 5 years post-index IPP discharge date were included in the study. Men without ED but with comparable characteristics were identified and used as a comparator group. Revenue received by hospitals from Medicare was defined as the sum of payments for patient services, other payor-paid amounts, patient deductibles, copayments, and coinsurance. Revenue was inflated to 2022 US dollars. The mean values and their corresponding standard deviations (SD) are reported.
After matching, there were 2905 men with ED who received an IPP and 7462 men without ED. The IPP cohort showed a significantly higher 5-year cumulative revenue (mean=$34,571 [SD=$50,234]) compared to the men without ED (mean=$3189 [SD=$11,527]). When stratified by diagnosis type, the differences in revenue were $10,258 for circulatory disease, $2646 for diabetes, $2013 for urology, and $1043 for prostate cancer. Significantly more IPP patients had at least 1 health encounter for these conditions over the 5-year follow-up period than their matched controls (55.0% vs 7.8% for circulatory, 46.7% vs 16.8% for urology, 19.3% vs 3.6% for diabetes, and 19.0% vs 3.0% for prostate cancer).
Men with ED who received IPP generated substantially higher revenue for the healthcare system over a 5-year period, nearly 10 times as much, compared to men without ED, excluding the initial cost of the IPP procedure. The presence of ED, coupled with IPP usage, is associated with significantly increased healthcare revenue across a range of medical conditions compared to men without ED. These findings emphasize the financial implications for advanced ED programs to improve access to necessary care for these patients. Healthcare facilities may leverage these insights to effectively allocate resources to deliver critical healthcare to men with ED.
量化因后续治疗而产生的增量下游收入，这些治疗针对的是接受可膨胀阴茎假体 (IPP) 治疗勃起功能障碍 (ED) 的男性，与未患有 ED 的男性相比。
使用 100%医疗保险标准分析文件，对 2016 年 1 月 1 日至 2021 年 12 月 31 日期间在医院门诊接受 IPP 植入术（当前程序术语 54405）以治疗 ED 的患者在 5 年内产生的收入进行回顾性索赔分析，并与未患有 ED 的男性进行倾向评分匹配队列比较。研究纳入了年龄在 65 岁及以上、患有 ED、在医院门诊接受 IPP 植入术（当前程序术语 54405）、在索引 IPP 前 12 个月和索引 IPP 出院后 5 年连续参加医疗保险 A 部分和 B 部分的患者，且具有可比性的男性。未患有 ED 但具有可比特征的男性被确定为对照组。医院从医疗保险中获得的收入定义为患者服务、其他支付方支付的金额、患者自付额、共同支付额和共同保险额的总和。收入按 2022 年美元进行了膨胀。报告了平均值及其相应的标准偏差（SD）。
匹配后，共有 2905 名患有 ED 的男性接受了 IPP 治疗，7462 名男性未患有 ED。IPP 队列显示出显著更高的 5 年累计收入（平均值=$34571 [SD=$50234]），与未患有 ED 的男性（平均值=$3189 [SD=$11527]）相比。按诊断类型分层，循环系统疾病的收入差异为$10258，糖尿病为$2646，泌尿科为$2013，前列腺癌为$1043。在 5 年随访期间，IPP 患者至少有 1 次与这些疾病相关的医疗就诊的比例显著高于匹配对照组（循环系统疾病为 55.0%比 7.8%，泌尿科为 46.7%比 16.8%，糖尿病为 19.3%比 3.6%，前列腺癌为 19.0%比 3.0%）。
与未患有 ED 的男性相比，患有 ED 并接受 IPP 治疗的男性在 5 年内产生的医疗保健系统收入要高得多，几乎高出 10 倍，不包括 IPP 手术的初始成本。ED 的存在加上 IPP 的使用，与未患有 ED 的男性相比，与一系列医疗状况相关的医疗保健收入显著增加。这些发现强调了为改善这些患者获得必要护理的机会而加强先进 ED 项目的财务意义。医疗机构可以利用这些见解，有效地分配资源为患有 ED 的男性提供关键的医疗保健。
