糖尿病黄斑的以患者为中心的经济负担:回顾性队列研究
Kyungseon Choi1,2, Sang Jun Park3, Hyuna Yoon1,2
1Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
JMIR public health and surveillance
|October 8, 2024
概括
糖尿病黄斑 (DME) 与单独的糖尿病 (DM) 相比,显著增加了患者的3年经济负担. 这凸显了需要更好的管理和治疗策略来降低患者成本的必要性.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 卫生经济学 卫生经济学
背景情况:
- 糖尿病黄斑 (DME) 是导致失明的主要原因,需要昂贵的治疗,如抗血管内皮生长因子 (VEGF) 药物.
- 长期使用这些治疗方法对患有DME的患者造成了相当大的经济负担,而不是那些没有DME的糖尿病患者.
- 关于DME在反VEGF退款后的长期,以患者为中心的经济影响的研究有限.
研究的目的:
- 估计DME的3年以患者为中心的经济负担,与没有DME的DM相比.
- 使用通用数据模型对医疗数据进行全面分析.
主要方法:
- 这是一项回顾性队列研究,使用来自首尔国立大学Bundang医院的1,903,603名患者记录 (2003-2020年),通过观察医学结果伙伴关系共同数据模型进行验证.
- 根据年龄>18岁,非增殖性糖尿病视网膜病变和抗VEGF/类固醇处方定义的DME组;根据没有这种处方的DM或糖尿病视网膜病变对照组.
- 员工倾向得分匹配和通用线性模型与零通胀模型,以估计患者为中心的增量经济负担和医疗保健资源利用在3年内.
主要成果:
- 与DM患者相比,在3年内,DME患者的总费用 (2.09倍),报销费用 (1.89倍),非报销费用 (2.54倍),自付费用 (2.11倍) 和保险覆盖费用 (2.01倍) 显著增加.
- DME组的门诊次数 (1.87倍) 和住院次数 (1.99倍) 较多 (P<.001).
结论:
- 患有DME的患者面临的经济负担比单独患有DM的患者要高得多.
- 现实世界的数据强调需要采取干预措施,如改进补偿政策,成本有效的治疗方法 (例如,贝瓦西祖马布) 和早期诊断策略,可能使用人工智能,以减轻患者的成本.
相关概念视频
01:27Open Angle Glaucoma: Treatment
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:27Diabetic Retinopathy
DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
01:28Diabetic Nephropathy
Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...