Huang Yinan, Li Jieni, Agarwal Sandeep Krishna
School of Pharmacy, University of Mississippi, University, Mississippi.
College of Pharmacy, University of Houston, Houston, Texas.
ACR Open Rheumatol. 2024 Nov;6(11):746-754. doi: 10.1002/acr2.11728. Epub 2024 Aug 6.
Our objective was to estimate the economic and humanistic burden among US adults with rheumatoid arthritis (RA).
This study analyzed results from the Medical Expenditure Panel Survey from 2018 to 2020. Adults (aged ≥18 years) self-reporting with RA or with the presence of the International Classification of Disease, 10th Revision clinical modification codes were identified. Healthcare expenditures (inpatient care, outpatient care, emergency department, office visits, prescription medications, home health, and others) were measured. The Short Form 12 Health Survey physical component summary (PCS), mental component summary (MCS), activities of daily living (ADL), and instrumental ADL (IADL) were measured. Two-part models assessed the incremental increase in the health care expenditures for the RA group compared to the non-RA group. In addition, the multivariable linear regression was used to evaluate the marginal difference in PCS and MCS between those with RA and those without RA, whereas the multivariable logistic regression models were used to evaluate the association between ADL and IADL by RA status.
Annually, 4.27 million adults with RA were identified. The two-part model showed significantly higher total annual healthcare expenditures in the RA group than non-RA group (mean $3,382.971 [95% confidence interval (CI) $1,816.50-$4,949.44]). Compared to the non-RA group, the RA group was associated with lower PCS scores (mean 4.78 [95% CI 3.47-6.09]) and similarly lower MCS scores (mean -0.84 [95% CI -2.18 to 0.50]), as well as increased odds of requesting ADL (adjusted odds ratio [aOR] 2.02 [95% CI 1.59-2.56]) and IADL assistance (aOR 2.11 [95% CI 1.57-2.84]).
RA was associated with higher health care expenditures, particularly prescription medication costs, and was associated with suboptimal quality of life.
我们的目的是评估美国类风湿关节炎(RA)成年患者的经济和人文负担。
本研究分析了2018年至2020年医疗支出面板调查的结果。确定了自我报告患有RA或存在国际疾病分类第10次修订临床修订代码的成年人(年龄≥18岁)。测量了医疗保健支出(住院护理、门诊护理、急诊科、门诊就诊、处方药、家庭保健等)。测量了简短健康调查问卷身体成分总结(PCS)、心理成分总结(MCS)、日常生活活动(ADL)和工具性日常生活活动(IADL)。两部分模型评估了RA组与非RA组相比医疗保健支出的增量增加。此外,多变量线性回归用于评估RA患者与非RA患者之间PCS和MCS的边际差异,而多变量逻辑回归模型用于评估RA状态与ADL和IADL之间的关联。
每年确定427万例RA成年患者。两部分模型显示,RA组的年度医疗保健总支出显著高于非RA组(平均3382.971美元[95%置信区间(CI)1816.50 - 4949.44美元])。与非RA组相比,RA组的PCS得分较低(平均4.78[95%CI 3.47 - 6.09]),MCS得分同样较低(平均 - 0.84[95%CI - 2.18至0.50]),以及请求ADL(调整优势比[aOR]2.02[95%CI 1.59 - 2.56])和IADL协助的几率增加(aOR 2.11[95%CI 1.57 - 2.84])。
RA与更高的医疗保健支出相关,尤其是处方药成本,并且与生活质量欠佳相关。