Gish Robert G, MacEwan Joanna P, Levine Alina, Lebovitch Dannielle, Bessonova Leona, Wheeler Darren, Nair Radhika, Bonder Alan
Robert G Gish Consultants, LLC, San Diego, CA 92037, USA.
Genesis Research Group, Hoboken, NJ 07030, USA.
J Comp Eff Res. 2025 Apr;14(4):e240174. doi: 10.57264/cer-2024-0174. Epub 2025 Mar 6.
To evaluate the clinical characteristics and healthcare resource utilization for acute care and its costs for patients with primary biliary cholangitis (PBC) with or without cirrhosis. This retrospective observational cohort study was conducted using two datasets (Komodo's Healthcare Map™ [Komodo Health] and Optum Clinformatics Data Mart [CDM] database) between 2015 and 2023. Patients (≥18 years) with PBC were identified based on ≥1 inpatient or ≥2 outpatient claims. Healthcare resource utilization for acute care (hospitalizations and emergency department [ED] visits [not leading to hospitalization]) were assessed in both datasets, and associated medical costs were evaluated in Optum CDM. In Komodo Health, of the 29,758 patients with PBC (mean age: 59.2 years), 21.6% had cirrhosis and 50.4% of patients with cirrhosis had Medicaid or Medicare coverage. Of the total 8143 patients in Optum CDM (mean age: 67.0 years), 20.7% had cirrhosis, and most were enrolled in Medicare (69.7%). There was a larger proportion of men in the cirrhosis group compared with the no-cirrhosis group in Komodo Health (31.7 vs 16.3%) and Optum CDM (29.7 vs 16.5%). Annually, among patients with cirrhosis who had a hospitalization, 69.3% had additional hospitalizations, and among patients who had an ED visit, 52.9% had additional ED visits in Komodo Health; similar results were observed in Optum CDM. Among patients with at least one acute-care event, the mean annual acute-care costs with and without cirrhosis were $113,568 and $47,436, respectively. Data from two large healthcare claims databases showed that the majority of patients who had at least one acute-care event experienced additional acute-care events, particularly among those with cirrhosis. Timely treatment to avoid hospitalization and disease progression may help mitigate the clinical and economic burden for patients with PBC.
评估原发性胆汁性胆管炎（PBC）伴或不伴肝硬化患者急性护理的临床特征、医疗资源利用情况及其成本。本回顾性观察队列研究使用了2015年至2023年期间的两个数据集（科莫多医疗地图™[科莫多健康公司]和Optum临床信息数据集市[CDM]数据库）。根据至少1次住院或至少2次门诊索赔确定PBC患者（≥18岁）。在两个数据集中评估急性护理的医疗资源利用情况（住院和急诊就诊[未导致住院]），并在Optum CDM中评估相关医疗成本。在科莫多健康公司，29758例PBC患者（平均年龄：59.2岁）中，21.6%患有肝硬化，50.4%的肝硬化患者有医疗补助或医疗保险覆盖。在Optum CDM的8143例患者（平均年龄：67.0岁）中，20.7%患有肝硬化，大多数参加了医疗保险（69.7%）。在科莫多健康公司，肝硬化组男性比例高于无肝硬化组（31.7%对16.3%），在Optum CDM中也是如此（29.7%对16.5%）。在科莫多健康公司，每年有住院治疗的肝硬化患者中，69.3%有额外住院，有急诊就诊的患者中，52.9%有额外急诊就诊；在Optum CDM中观察到类似结果。在至少有一次急性护理事件的患者中，有肝硬化和无肝硬化患者的年平均急性护理成本分别为113568美元和47436美元。来自两个大型医疗索赔数据库的数据显示，大多数至少有一次急性护理事件的患者经历了额外的急性护理事件，尤其是在肝硬化患者中。及时治疗以避免住院和疾病进展可能有助于减轻PBC患者的临床和经济负担。
