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健康相关生命质量 RAND12 与癌症伴睡眠障碍患者医疗资源利用:来自医疗支出面板调查的见解。

Health-related quality of life by veterans RAND 12 and healthcare resource utilization in cancer patients with sleep disorders: insights from the Medical Expenditure Panel Survey.

机构信息

Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.

Department of Medicine Science Industries, Chang Jung Christian University, Tainan, Taiwan.

出版信息

Support Care Cancer. 2024 Jun 19;32(7):443. doi: 10.1007/s00520-024-08658-1.

Abstract

PURPOSE

This study aims to investigate the joint effects of cancer and sleep disorders on the health-related quality of life (HRQoL), healthcare resource utilization, and expenditures among US adults.

METHODS

Utilizing the 2018-2019 Medical Expenditure Panel Survey (MEPS) database, a sample of 25,274 participants was categorized into four groups based on cancer and sleep disorder status. HRQoL was assessed using the VR-12 questionnaire. Generalized linear model (GLM) with a log-linear regression model combined gamma distribution was applied for the analysis of healthcare expenditure data.

RESULTS

Individuals with both cancer and sleep disorders (C+/S+) exhibited notably lower physical health (PCS) and mental health (MCS) scores-1.45 and 1.87 points lower, respectively. They also showed significantly increased clinic visits (2.12 times), outpatient visits (3.59 times), emergency visits (1.69 times), and total medical expenditures (2.08 times) compared to those without cancer or sleep disorders (C-/S-). In contrast, individuals with sleep disorders alone (C-/S+) had the highest number of prescription drug usage (2.26 times) and home health care days (1.76 times) compared to the reference group (C-/S-).

CONCLUSIONS

Regardless of cancer presence, individuals with sleep disorders consistently reported compromised HRQoL. Furthermore, those with cancer and sleep disorders experienced heightened healthcare resource utilization, underscoring the considerable impact of sleep disorders on overall quality of life.

IMPLICATIONS FOR CANCER SURVIVORS

The findings of this study address the importance of sleep disorders among cancer patients and their potential implications for cancer care. Healthcare professionals should prioritize screening, education, and tailored interventions to support sleep health in this population.

摘要

目的

本研究旨在探讨癌症和睡眠障碍对美国成年人健康相关生活质量(HRQoL)、医疗资源利用和支出的联合影响。

方法

利用 2018-2019 年医疗支出面板调查(MEPS)数据库,根据癌症和睡眠障碍状况,将 25274 名参与者分为四组。使用 VR-12 问卷评估 HRQoL。采用广义线性模型(GLM)与对数线性回归模型相结合的伽马分布对医疗支出数据进行分析。

结果

同时患有癌症和睡眠障碍的个体(C+/S+)表现出明显较低的生理健康(PCS)和心理健康(MCS)评分,分别低 1.45 和 1.87 分。与无癌症或睡眠障碍的个体(C-/S-)相比,他们的就诊次数(增加 2.12 倍)、门诊就诊次数(增加 3.59 倍)、急诊就诊次数(增加 1.69 倍)和总医疗支出(增加 2.08 倍)也显著增加。相比之下,仅患有睡眠障碍的个体(C-/S+)的处方药使用次数(增加 2.26 倍)和家庭保健天数(增加 1.76 倍)最高,高于参考组(C-/S-)。

结论

无论是否存在癌症,患有睡眠障碍的个体始终报告 HRQoL 受损。此外,患有癌症和睡眠障碍的个体经历了更高的医疗资源利用,突出了睡眠障碍对整体生活质量的重大影响。

对癌症幸存者的启示

本研究结果强调了癌症患者中睡眠障碍的重要性及其对癌症护理的潜在影响。医疗保健专业人员应优先考虑对该人群进行筛查、教育和量身定制的干预措施,以支持其睡眠健康。

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