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美国周期性呕吐综合征的生产力损失与间接负担

Productivity Loss and Indirect Burden of Cyclic Vomiting Syndrome in the United States.

作者信息

Song Xue, Chen Yaozhu J, Perry Allison, Kagan Jerry, Bhandari Sanjay, Almansa Cristina, Richmond Camilla, Levinthal David J, Venkatesan Thangam

机构信息

IBM Watson Health, Cambridge, Massachusetts.

Takeda Development Center Americas, Inc., Cambridge, Massachusetts.

出版信息

Gastro Hep Adv. 2022 Jul 21;1(6):954-962. doi: 10.1016/j.gastha.2022.06.017. eCollection 2022.

Abstract

BACKGROUND AND AIMS

To quantify the indirect burden of cyclic vomiting syndrome (CVS), we assessed work-related productivity loss in patients with CVS and caregivers using large-sized databases in the United States.

METHODS

Patients aged 18-64 years with full-time employment in MarketScan Commercial and Health and Productivity Management Databases were selected if they had ≥1 inpatient or ≥2 outpatient claims for CVS between 2008 and 2018 and continuous enrollment of ≥6 months before and ≥3 months after the initial CVS diagnosis. CVS caregivers were adults with full-time employment and also having dependent(s) with CVS. Propensity scores via multivariable regressions were used to match patients with CVS and their caregivers to non-CVS controls. Productivity loss was assessed by short-term disability (STD) and absenteeism (ABS) days, and the associated costs were also calculated. Differences between the matched cohorts were regarded as the burden attributable to CVS.

RESULTS

Patients with CVS had longer annualized STD (21.1 vs 7.0, < .001) and ABS days (26.4 vs 22.8, < .05) than their matched controls. CVS caregivers had more annualized STD (3.9 vs 2.6,  < .001) and ABS days (20.9 vs 19.5, < .05) than controls. Productivity loss costs for STD or ABS days were greater for patients with CVS and caregivers. Annualized health-care resource utilization (inpatient, emergency room, outpatient) was 5.2-6.0 times higher in patients with CVS ( < .001).

CONCLUSION

CVS is associated with higher productivity loss due to STD/ABS and, therefore, greater indirect costs for patients and caregivers. Further research is needed to assess the full societal burden of CVS. More effective interventions may reduce the disease burden.

摘要

背景与目的

为了量化周期性呕吐综合征(CVS)的间接负担,我们利用美国的大型数据库评估了CVS患者及其照料者与工作相关的生产力损失。

方法

从MarketScan商业及健康与生产力管理数据库中选取年龄在18 - 64岁且全职工作的患者,条件为在2008年至2018年期间有≥1次CVS住院索赔或≥2次门诊索赔,且在首次CVS诊断前连续参保≥6个月、诊断后连续参保≥3个月。CVS照料者为全职工作且有患CVS的受抚养人的成年人。通过多变量回归得出的倾向得分用于将CVS患者及其照料者与非CVS对照进行匹配。通过短期残疾(STD)天数和旷工(ABS)天数评估生产力损失,并计算相关成本。匹配队列之间的差异被视为CVS所致的负担。

结果

与匹配的对照组相比,CVS患者的年化STD天数(21.1天对7.0天,P <.001)和ABS天数(26.4天对22.8天,P <.05)更长。CVS照料者的年化STD天数(3.9天对2.6天,P <.001)和ABS天数(20.9天对19.5天,P <.05)比对照组更多。CVS患者及其照料者因STD或ABS天数导致的生产力损失成本更高。CVS患者的年化医疗资源利用率(住院、急诊室、门诊)高出5.2 - 6.0倍(P <.001)。

结论

CVS因STD/ABS导致更高的生产力损失,因此给患者及其照料者带来更大的间接成本。需要进一步研究以评估CVS的全部社会负担。更有效的干预措施可能会减轻疾病负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/353f/11307938/58741c16fa66/gr1.jpg

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