与酸相关疾病对健康维护组织造成的成本。

Costs of acid-related disorders to a health maintenance organization.

作者信息

Levin T R, Schmittdiel J A, Kunz K, Henning J M, Henke C J, Colby C J, Selby J V

机构信息

Division of Gastroenterology, University of California, San Francisco, USA.

出版信息

Am J Med. 1997 Dec;103(6):520-8. doi: 10.1016/s0002-9343(97)00308-2.

DOI:10.1016/s0002-9343(97)00308-2

PMID:9428836

Abstract

BACKGROUND

Little is known about the economic impact of the acid-related disorders (ARDs), which include dyspepsia, gastritis, gastroesophageal reflux disease (GERD), and peptic ulcer disease (PUD), in managed care patient populations.

OBJECTIVES

To describe the prevalence of medically attended ARDs, and their direct medical costs from the perspective of a large health maintenance organization (HMO).

METHODS

A total of 1,550 ARDs subjects (age > or = 18 years), were randomly sampled from outpatient diagnosis and pharmacy databases of the Kaiser Permanente Medical Care Program of Northern California and verified by chart review. Five age- and gender-matched controls were identified per subject. One-year prevalence, excess annual costs, and initial 6-month costs for incident cases were estimated using the HMO cost accounting system.

RESULTS

Total ARDs prevalence (5.8%) increases with advancing age. GERD is the most common ARD (2.9% overall prevalence). Annual per person attributable costs were $1,183, $471, and $431 respectively for PUD, GERD, and gastritis/dyspepsia. Excess inpatient costs for PUD explain its higher costs. Outpatient costs were somewhat higher for GERD ($279) than for PUD or gastritis/dyspepsia. Pharmacy costs were relatively low for each condition, in part because many patients were treated with generic cimetidine. Total annual HMO expenditures for ARDs were $59.4 million, with 40.6%, 36.8%, and 22.6% respectively for GERD, PUD, and gastritis/dyspepsia.

CONCLUSIONS

Acid-related disorders, particularly GERD and PUD, contribute substantially to the direct costs of medical care in this managed care population.

摘要

背景

在管理式医疗患者群体中，关于酸相关性疾病（ARDs），包括消化不良、胃炎、胃食管反流病（GERD）和消化性溃疡病（PUD）的经济影响，人们所知甚少。

目的

从一个大型健康维护组织（HMO）的角度描述就医的ARDs的患病率及其直接医疗费用。

方法

从北加利福尼亚凯撒永久医疗计划的门诊诊断和药房数据库中随机抽取总共1550名ARDs患者（年龄≥18岁），并通过病历审查进行核实。为每位患者确定5名年龄和性别匹配的对照。使用HMO成本核算系统估计1年患病率、年度额外费用以及新发病例的初始6个月费用。

结果

ARDs总患病率（5.8%）随年龄增长而增加。GERD是最常见的ARD（总体患病率为2.9%）。PUD、GERD和胃炎/消化不良的人均年度归因费用分别为1183美元、471美元和431美元。PUD较高的费用是由其较高的住院费用所致。GERD的门诊费用（279美元）略高于PUD或胃炎/消化不良。每种疾病的药房费用相对较低，部分原因是许多患者使用的是西咪替丁通用制剂。ARDs的HMO年度总支出为5940万美元，其中GERD、PUD和胃炎/消化不良分别占40.6%、36.8%和22.6%。