与医疗保险优势登记者中轻微减少功能进展相关的成本
Clarissa J Diamantidis1,2,3, Amy Storfer-Isser4, Ezra Fishman5,6
1Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina.
Kidney medicine
|May 30, 2023
概括
早期慢性病 (CKD) 的老年人表现出不同的进展. 与稳定的CKD患者相比,患有加速功能衰退的患者的医疗保健费用增加了两倍.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 卫生经济学 卫生经济学
- 老年病的医生 老年病的医生
背景情况:
- 在老年人中,早期慢性病 (CKD) 的患病率增加.
- 尽管早期诊断,但CKD进展的变化.
- 关于CKD进展轨迹与医疗保健成本之间的关联的不确定性.
研究的目的:
- 为了估计医疗保险优势 (MA) 登记者的CKD进展轨迹.
- 检查与每个确定轨迹相关的MA医疗保健成本.
- 分析3年内对患有轻度功能下降的个体的成本.
主要方法:
- 队列研究设计.
- 在2014-2017年期间,对421,187名被诊断患有G2阶段CKD的MA注册者的分析.
- 识别了五个不同的功能 (eGFR) 轨迹随时间的推移.
主要成果:
- 确定了五种功能轨迹:稳定,两个缓慢下降,急剧下降和加速下降.
- 在研究开始时,平均eGFR为75.9mL/min/1.73m2.
- 加快eGFR下降的登记者成本是其他轨迹的两倍 (27,738美元与13,498美元在进入后一年).
结论:
- 一小部分MA注册的加速CKD进展的患者经历了不成比例的高医疗费用.
- 了解这些成本差异对于管理CKD护理资源至关重要.
- 进一步的研究应该考虑白蛋白水平,以便进行更全面的分析.
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