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多发性硬化症的医疗保健利用情况:明尼苏达州奥尔姆斯特德县的一项基于人群的研究。

Health care utilization in multiple sclerosis: a population-based study in Olmsted County, MN.

作者信息

Stolp-Smith K A, Atkinson E J, Campion M E, O'Brien P C, Rodriguez M

机构信息

Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

Neurology. 1998 Jun;50(6):1594-600. doi: 10.1212/wnl.50.6.1594.

Abstract

OBJECTIVE

The authors sought to determine acute ambulatory- and hospital-billed charges for the Olmsted County, Minnesota Multiple Sclerosis (MS) Disability Prevalence Cohort and compare them to those incurred by the general population.

METHODS

Billed charges for 155 people with clinically definite or laboratory-supported MS were compared with those of age- and gender-matched non-MS controls. Billing data, including all inpatient and outpatient acute and rehabilitative medical care charges over a 5-year period surrounding a December 1, 1991 prevalence date, were analyzed. Data were correlated with level of disability using the Minimal Record of Disability for MS.

RESULTS

Median total annual billed charges for most individuals with MS, including those with less severe ($1,277) and relapsing-remitting illness ($1,348), did not differ from those for controls ($1,327, p=0.075). Only those with severe MS (22.6%) had median annual medical charges higher than controls ($5,440, p < 0.001). Male patients with MS had higher median annual total charges ($2,353) than male controls ($762, p=0.003). Total charges for female patients with MS ($1,440) were not different from those for female controls ($1469). Median annual outpatient charges were 15% more for the MS group ($1,418) than for controls ($1,231). Patients with MS had a mean of 0.2 hospital admissions annually compared with 0.1 annual admissions per control patient. Among variables collected on persons with MS, the Expanded Disability Status Scale was the strongest predictor of level of charges (p < 0.001).

CONCLUSION

Acute ambulatory- and hospital-billed charges for most patients with MS do not differ from those of the general population.

摘要

目的

作者试图确定明尼苏达州奥尔姆斯特德县多发性硬化症(MS)残疾患病率队列的急性门诊和住院费用,并将其与普通人群的费用进行比较。

方法

将155例临床确诊或实验室支持的MS患者的计费费用与年龄和性别匹配的非MS对照者的费用进行比较。分析了计费数据,包括1991年12月1日患病率日期前后5年期间的所有住院和门诊急性及康复医疗费用。使用MS残疾最小记录将数据与残疾水平相关联。

结果

大多数MS患者,包括病情较轻者(1277美元)和复发缓解型患者(1348美元)的年度总计费中位数与对照组(1327美元,p = 0.075)无差异。只有重度MS患者(22.6%)的年度医疗费用中位数高于对照组(5440美元,p < 0.001)。男性MS患者的年度总费用中位数(2353美元)高于男性对照组(762美元,p = 0.003)。女性MS患者的总费用(1440美元)与女性对照组(1469美元)无差异。MS组的年度门诊费用中位数(1418美元)比对照组(1231美元)高15%。MS患者每年平均住院0.2次,而对照患者每年平均住院0.1次。在收集的MS患者变量中,扩展残疾状态量表是费用水平的最强预测因子(p < 0.001)。

结论

大多数MS患者的急性门诊和住院费用与普通人群无差异。

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