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对美国商业保险覆盖的侵袭性脑膜炎球菌病确诊患者的健康和经济负担进行回顾性分析。

Retrospective analysis of health and economic burden among commercially-insured individuals diagnosed with invasive meningococcal disease in the United States.

作者信息

Herrera-Restrepo Oscar, Kwiatkowska Marta, Huse Samuel, Kocaata Zeki, Ganz Michael L

机构信息

US Health Economics & Outcomes Research, GSK, Philadelphia, PA, USA.

Data & Analytics, Evidera, London, UK.

出版信息

Hum Vaccin Immunother. 2024 Dec 31;20(1):2436039. doi: 10.1080/21645515.2024.2436039. Epub 2024 Dec 16.

DOI:10.1080/21645515.2024.2436039
PMID:39681338
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11651274/
Abstract

Invasive meningococcal disease (IMD) is a life-threatening yet vaccine-preventable disease, with vaccines approved and recommended in the United States by the Centers for Disease Control and Prevention. This study assessed complications, mortality, healthcare resource utilization (HCRU), and healthcare costs among a sample of commercially-insured individuals living in the United States who experienced IMD. We used retrospective data from large claims databases limited to individuals with IMD covered by commercial health plans between January 2010-March 2022. Health outcomes, HCRU, and healthcare costs were analyzed during the acute (index date to 30 days post-hospital discharge) and post-acute (end of acute phase to end of follow-up period) phases. Among 618 IMD cases identified, the most common acute phase complications were severe brain damage, renal failure, and autoimmune disease. The most common post-acute phase complications were autoimmune disease, arthralgia, and renal failure. Acute phase HCRU ranged from 72.7 (95% confidence interval [CI] 19.81-186.12) intensive care unit (ICU) stays to 12,102.9 (95% CI 11,201.07-13,058.00) surgeries per 1,000 patient-years. Post-acute phase HCRU ranged from 3.6 (95% CI 1.18-8.50) ICU stays to 7,808.3 (95% CI 7,661.22-7,957.54) specialty physician visits per 1,000 patient-years. Patients with IMD incurred average healthcare costs of $60,866.23 and $145,883.65 during the acute and post-acute phases, respectively. Negative health outcomes and high HCRU and costs were observed among commercially-insured patients with IMD. Our findings suggest that IMD immunization efforts and healthcare interventions targeting education on vaccine recommendations to healthcare providers and patients could help prevent IMD and reduce disease burden.

摘要

侵袭性脑膜炎球菌病(IMD)是一种危及生命但可通过疫苗预防的疾病,美国疾病控制与预防中心已批准并推荐使用相关疫苗。本研究评估了美国商业保险覆盖的经历过IMD的个体样本中的并发症、死亡率、医疗资源利用(HCRU)及医疗费用。我们使用了大型索赔数据库的回顾性数据,这些数据仅限于2010年1月至2022年3月期间由商业健康保险计划承保的IMD患者。在急性期(索引日期至出院后30天)和急性后期(急性期结束至随访期结束)分析了健康结局、HCRU及医疗费用。在618例确诊的IMD病例中,最常见的急性期并发症为严重脑损伤、肾衰竭和自身免疫性疾病。最常见的急性后期并发症为自身免疫性疾病、关节痛和肾衰竭。急性期HCRU范围为每1000患者年72.7次(95%置信区间[CI] 19.81 - 186.12)重症监护病房(ICU)住院至12,102.9次(95% CI 11,201.07 - 13,058.00)手术。急性后期HCRU范围为每1000患者年3.6次(95% CI 1.18 - 8.50)ICU住院至7,808.3次(95% CI 7,661.22 - 7,957.54)专科医生就诊。IMD患者在急性期和急性后期的平均医疗费用分别为$60,866.23和$145,883.65。在商业保险的IMD患者中观察到不良健康结局以及高HCRU和费用。我们的研究结果表明,针对医疗服务提供者和患者开展疫苗推荐教育的IMD免疫接种工作和医疗干预措施有助于预防IMD并减轻疾病负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a99b/11651274/21ec67113e4a/KHVI_A_2436039_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a99b/11651274/1adfe585f818/KHVI_A_2436039_UF0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a99b/11651274/21ec67113e4a/KHVI_A_2436039_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a99b/11651274/1adfe585f818/KHVI_A_2436039_UF0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a99b/11651274/21ec67113e4a/KHVI_A_2436039_F0001_OC.jpg

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