在有状细胞病的商业和医疗保险成年人中比较超级使用者和低使用者
Sarah R MacEwan1,2, ChienWei Chiang3,4, Sarah H O'Brien5
1Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH.
Blood advances
|November 22, 2023
概括
患有状细胞疾病 (SCD) 的超级使用者承担的医疗保健费用明显更高. 门诊护理对这些支出做出了重大贡献,即使在那些疼痛发作较少的人群中也是如此.
科学领域:
- 卫生经济学 卫生经济学
- 血液学 血液学 血液学
- 公共卫生 公共卫生
背景情况:
- 状细胞疾病 (SCD) 是美国罕见且昂贵的疾病.
- 超级使用者,即高医疗利用率的个体,在其他疾病中已知,但在SCD中未得到充分研究.
- 了解SCD超级用户对于资源配置和护理管理至关重要.
研究的目的:
- 描述医疗保健支出和超级使用者与SCD的接触.
- 为了比较超级用户与低用户在整体和与疼痛相关的医疗保健利用方面.
- 在SCD超级使用者群体中确定高医疗保健成本的驱动因素.
主要方法:
- 使用MarketScan和Medicare索赔 (2016-2020) 的回顾性纵向队列研究.
- 确定了患有SCD的成年人,并将他们分为支出组:超级使用者 (前10%) 和低使用者.
- 使用后勤回归分析了住院,门诊和急诊部的遭遇和支出.
主要成果:
- 超级用户的年度支出比低用户 (商业保险) 高43.46倍,比低用户 (医疗保险) 高13.37倍.
- 在超级使用者和低使用者之间观察到总体医疗保健遭遇和疼痛事件遭遇的显著差异.
- 在超级用户中,一些疼痛事件很少发生的患者的门诊费用比许多疼痛事件发生的患者高.
结论:
- 在SCD中过度利用与医疗保健支出大幅增加有关.
- 昂贵的门诊护理是SCD超级用户中高成本的重要贡献者.
- 需要进一步的研究,以了解SCD超级用户,以针对性预防和治疗干预.
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