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白癜风患者及合并心理社会疾病患者的医疗资源使用与成本:对美国参保人群的回顾性分析

Healthcare Resource Use and Costs Among Individuals with Vitiligo and Psychosocial Comorbidities: Retrospective Analysis of an Insured US Population.

作者信息

Lofland Jennifer H, Darbha Samyuktha, Naim Ahmad B, Rosmarin David

机构信息

US Medical Affairs, Incyte Corporation, Wilmington, DE, USA.

Health Economics and Outcomes Research, Datawave Solutions Corp, Cranbury, NJ, USA.

出版信息

Clinicoecon Outcomes Res. 2024 Aug 8;16:557-565. doi: 10.2147/CEOR.S463987. eCollection 2024.

Abstract

PURPOSE

This study aimed to describe healthcare resource utilization and costs among individuals with vitiligo who were diagnosed with ≥1 psychosocial comorbidity, using data from US claims databases.

PATIENTS AND METHODS

A retrospective, observational cohort analysis of the IBM MarketScan Commercial and Medicare supplemental claims databases for US individuals with vitiligo aged ≥12 years and a first vitiligo claim between January 1 and December 31, 2018, was undertaken to assess psychosocial burden, including mental and behavioral health comorbidities.

RESULTS

Of the 12,427 individuals included in the analysis, nearly 1 in 4 (23.5%) who had vitiligo were also diagnosed with ≥1 psychosocial comorbidity. A greater percentage of these individuals versus those who were not diagnosed with a psychosocial comorbidity had a vitiligo-related prescription claim (50.2% vs 45.4%; <0.0001), especially for oral corticosteroids (25.4% vs 16.6%; <0.0001) and low-potency topical corticosteroids (9.0% vs 7.6%; <0.05). Total vitiligo-related healthcare resource utilization and costs were consistent among individuals with and without psychosocial comorbidity despite significantly (<0.05) higher vitiligo-related ER visit utilization and expenditure among those with psychosocial comorbidity. Furthermore, individuals diagnosed with vitiligo and ≥1 psychosocial comorbidity had significantly (<0.0001) greater utilization of all-cause mean prescription claims (25.0 vs 12.8), outpatient services (other than physician and ER visits: 19.5 vs 11.3), outpatient physician visits (10.1 vs 6.4), inpatient stays (0.6 vs 0.1), and ER visits (0.4 vs 0.2) and incurred significantly higher mean (SD) direct medical expenditures ($18,804 [$46,621] vs $9833 [$29,094] per patient per year; <0.0001).

CONCLUSION

Individuals with vitiligo who were diagnosed with ≥1 psychosocial comorbidity incurred greater total all-cause but not vitiligo-related healthcare resource utilization and expenditures than those without diagnosis of psychosocial comorbidities. Identification of psychosocial comorbidities in individuals with vitiligo may be important for multidisciplinary management of vitiligo to reduce overall burden for individuals with vitiligo.

摘要

目的

本研究旨在利用美国索赔数据库的数据,描述被诊断患有≥1种心理社会合并症的白癜风患者的医疗资源利用情况和费用。

患者与方法

对IBM MarketScan商业和医疗保险补充索赔数据库进行回顾性观察队列分析,纳入年龄≥12岁且在2018年1月1日至12月31日期间首次提出白癜风索赔的美国白癜风患者,以评估心理社会负担,包括精神和行为健康合并症。

结果

在分析纳入的12427名患者中,近四分之一(23.5%)患有白癜风的患者也被诊断患有≥1种心理社会合并症。与未被诊断患有心理社会合并症的患者相比,这些患者中有更高比例的人有白癜风相关的处方索赔(50.2%对45.4%;<0.0001),尤其是口服皮质类固醇(25.4%对16.6%;<0.0001)和低效局部皮质类固醇(9.0%对7.6%;<0.05)。尽管患有心理社会合并症者的白癜风相关急诊就诊利用率和支出显著更高(<0.05),但有和没有心理社会合并症的患者的白癜风相关医疗资源总利用情况和费用是一致的。此外,被诊断患有白癜风且有≥1种心理社会合并症的患者在全因平均处方索赔(25.0对12.8)、门诊服务(不包括医生和急诊就诊:19.5对11.3)、门诊医生就诊(10.1对6.4)、住院(0.6对0.1)和急诊就诊(0.4对0.2)方面的利用率显著更高(<0.0001),并且平均(标准差)直接医疗费用显著更高(每位患者每年18804美元[46621美元]对9833美元[29094美元];<0.0001)。

结论

被诊断患有≥1种心理社会合并症的白癜风患者在全因方面的医疗资源利用和支出总量高于未被诊断患有心理社会合并症的患者,但白癜风相关的医疗资源利用和支出并非如此。识别白癜风患者的心理社会合并症对于白癜风的多学科管理可能很重要,以减轻白癜风患者的总体负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd89/11318603/a753682ae024/CEOR-16-557-g0001.jpg

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