PDF(Pubmed)
Abstract：
BACKGROUND: Hypoparathyroidism (HP) is a rare endocrine disease commonly caused by the removal or damage of parathyroid glands during surgery and resulting in transient (tHP) or chronic (cHP) disease. cHP is associated with multiple complications and comorbid conditions; however, the economic burden has not been well characterized. The objective of this study was to evaluate the healthcare resource utilization (HCRU) and costs associated with post-surgical cHP, using tHP as a reference.
METHODS: This analysis of a US claims database included patients with both an insurance claim for HP and thyroid/neck surgery between October 2014 and December 2019. cHP was defined as an HP claim ≥ 6 months following surgery and tHP was defined as only one HP claim < 6 months following surgery. The cHP index date was the first HP diagnosis claim following their qualifying surgery claim, whereas the tHP index date was the last HP diagnosis claim following the qualifying surgery claim. Patients were continuously enrolled at least 1 year pre- and post-index. Patients\' demographic and clinical characteristics, all-cause HCRU, and costs were descriptively analyzed. Total all-cause costs were calculated as the sum of payments for hospitalizations, emergency department, office/clinic visits, and pharmacy.
RESULTS: A total of 1,406 cHP and 773 tHP patients met inclusion criteria. The average age (52.1 years cHP, 53.5 years tHP) and representation of females (83.2% cHP, 81.2% tHP) were similar for both groups. Neck dissection surgery was more prevalent in cHP patients (23.6%) than tHP patients (5.3%). During the 1-2 year follow-up period, cHP patients had a higher prevalence of inpatient admissions (17.4%), and emergency visits (26.0%) than the reference group -tHP patients (14.4% and 21.4% respectively). Among those with a hospitalization, the average number of hospitalizations was 1.5-fold higher for cHP patients. cHP patients also saw more specialists, including endocrinologists (28.7% cHP, 15.8% tHP), cardiologists (16.7% cHP, 9.7% tHP), and nephrologists (4.6% cHP, 3.3% tHP).
CONCLUSIONS: This study demonstrates the increased healthcare burden of cHP on the healthcare system in contrast to patients with tHP. Effective treatment options are needed to minimize the additional resources utilized by patients whose HP becomes chronic.
METHODS: This analysis of a US claims database included patients with both an insurance claim for HP and thyroid/neck surgery between October 2014 and December 2019. cHP was defined as an HP claim ≥ 6 months following surgery and tHP was defined as only one HP claim < 6 months following surgery. The cHP index date was the first HP diagnosis claim following their qualifying surgery claim, whereas the tHP index date was the last HP diagnosis claim following the qualifying surgery claim. Patients were continuously enrolled at least 1 year pre- and post-index. Patients\' demographic and clinical characteristics, all-cause HCRU, and costs were descriptively analyzed. Total all-cause costs were calculated as the sum of payments for hospitalizations, emergency department, office/clinic visits, and pharmacy.
RESULTS: A total of 1,406 cHP and 773 tHP patients met inclusion criteria. The average age (52.1 years cHP, 53.5 years tHP) and representation of females (83.2% cHP, 81.2% tHP) were similar for both groups. Neck dissection surgery was more prevalent in cHP patients (23.6%) than tHP patients (5.3%). During the 1-2 year follow-up period, cHP patients had a higher prevalence of inpatient admissions (17.4%), and emergency visits (26.0%) than the reference group -tHP patients (14.4% and 21.4% respectively). Among those with a hospitalization, the average number of hospitalizations was 1.5-fold higher for cHP patients. cHP patients also saw more specialists, including endocrinologists (28.7% cHP, 15.8% tHP), cardiologists (16.7% cHP, 9.7% tHP), and nephrologists (4.6% cHP, 3.3% tHP).
CONCLUSIONS: This study demonstrates the increased healthcare burden of cHP on the healthcare system in contrast to patients with tHP. Effective treatment options are needed to minimize the additional resources utilized by patients whose HP becomes chronic.
摘要：
背景：甲状旁腺功能减退症（HP）是一种罕见的内分泌疾病，通常由手术期间甲状旁腺的去除或损伤引起，并导致短暂性（tHP）或慢性（cHP）疾病。cHP与多种并发症和合并症相关；然而，经济负担没有得到很好的描述。本研究的目的是评估与术后cHP相关的医疗资源利用率（HCRU）和成本，使用tHP作为参考。
方法：对美国索赔数据库的分析包括2014年10月至2019年12月期间接受HP保险索赔和甲状腺/颈部手术的患者。cHP定义为手术后≥6个月的HP索赔，tHP定义为手术后<6个月的HP索赔。cHP指数日期是他们的合格手术索赔后的第一个HP诊断索赔，而tHP指数日期是符合资格的手术索赔后的最后一次HP诊断索赔.患者在指数之前和之后至少1年连续入组。患者的人口统计学和临床特征，全因HCCU,和成本进行了描述性分析。所有原因的总费用计算为住院付款的总和，急诊科,办公室/诊所就诊，和药房。
结果：共有1,406例cHP和773例tHP患者符合纳入标准。平均年龄(52.1岁cHP，53.5岁tHP)和女性代表(83.2%cHP，81.2%tHP)两组相似。cHP患者（23.6％）比tHP患者（5.3％）更普遍。在1-2年的随访期间，cHP患者住院率较高(17.4%)，和急诊就诊（26.0%）比参照组-tHP患者（分别为14.4%和21.4%）。在那些住院的人中，cHP患者的平均住院次数高出1.5倍.cHP患者也看了更多的专家，包括内分泌学家(28.7%cHP，15.8%tHP)，心脏病专家（16.7%cHP，9.7%tHP)，和肾病学家(4.6%cHP，3.3%tHP）。
结论：本研究表明，与tHP患者相比，cHP对医疗系统的医疗负担增加。需要有效的治疗选择，以最大程度地减少HP成为慢性患者的额外资源。
方法：对美国索赔数据库的分析包括2014年10月至2019年12月期间接受HP保险索赔和甲状腺/颈部手术的患者。cHP定义为手术后≥6个月的HP索赔，tHP定义为手术后<6个月的HP索赔。cHP指数日期是他们的合格手术索赔后的第一个HP诊断索赔，而tHP指数日期是符合资格的手术索赔后的最后一次HP诊断索赔.患者在指数之前和之后至少1年连续入组。患者的人口统计学和临床特征，全因HCCU,和成本进行了描述性分析。所有原因的总费用计算为住院付款的总和，急诊科,办公室/诊所就诊，和药房。
结果：共有1,406例cHP和773例tHP患者符合纳入标准。平均年龄(52.1岁cHP，53.5岁tHP)和女性代表(83.2%cHP，81.2%tHP)两组相似。cHP患者（23.6％）比tHP患者（5.3％）更普遍。在1-2年的随访期间，cHP患者住院率较高(17.4%)，和急诊就诊（26.0%）比参照组-tHP患者（分别为14.4%和21.4%）。在那些住院的人中，cHP患者的平均住院次数高出1.5倍.cHP患者也看了更多的专家，包括内分泌学家(28.7%cHP，15.8%tHP)，心脏病专家（16.7%cHP，9.7%tHP)，和肾病学家(4.6%cHP，3.3%tHP）。
结论：本研究表明，与tHP患者相比，cHP对医疗系统的医疗负担增加。需要有效的治疗选择，以最大程度地减少HP成为慢性患者的额外资源。
