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Abstract：
BACKGROUND: Pulmonary hypertension due to interstitial lung disease (PH-ILD) is associated with high rates of respiratory failure and death. Healthcare resource utilization (HCRU) and cost data are needed to characterize PH-ILD disease burden.
METHODS: A retrospective cohort analysis of the Truven Health MarketScan® Commercial Claims and Encounters Database and Medicare Supplemental Database between June 2015 to June 2019 was conducted. Patients with ILD were identified and indexed based on their first claim with a PH diagnosis. Patients were required to be 18 years of age on the index date and continuously enrolled for 12-months pre- and post-index. Patients were excluded for having a PH diagnosis prior to ILD diagnosis or the presence of other non-ILD, PH-associated conditions. Treatment patterns, HCRU, and healthcare costs were compared between the 12 months pre- versus 12 months post-index date.
RESULTS: In total, 122 patients with PH-ILD were included (mean [SD] age, 63.7 [16.6] years; female, 64.8%). The same medication classes were most frequently used both pre- and post-index (corticosteroids: pre-index 43.4%, post-index 53.5%; calcium channel blockers: 25.4%, 36.9%; oxygen: 12.3%, 25.4%). All-cause hospitalizations increased 2-fold, with 29.5% of patients hospitalized pre-index vs. 59.0% post-index (P < 0.0001). Intensive care unit (ICU) utilization increased from 6.6 to 17.2% (P = 0.0433). Mean inpatient visits increased from 0.5 (SD, 0.9) to 1.1 (1.3) (P < 0.0001); length of stay (days) increased from 5.4 (5.9) to 7.5 (11.6) (P < 0.0001); bed days from 2.5 (6.6) to 8.0 (16.3) (P < 0.0001); ICU days from 3.8 (2.3) to 7.0 (13.2) (P = 0.0362); and outpatient visits from 24.5 (16.8) to 32.9 (21.8) (P < 0.0001). Mean (SD) total all-cause healthcare costs increased from $43,201 ($98,604) pre-index to $108,387 ($190,673) post-index (P < 0.0001); this was largely driven by hospitalizations (which increased from a mean [SD] of $13,133 [$28,752] to $63,218 [$75,639] [P < 0.0001]) and outpatient costs ($16,150 [$75,639] to $25,604 [$93,964] [P < 0.0001]).
CONCLUSIONS: PH-ILD contributes to a high HCRU and cost burden. Timely identification, management, and treatment are needed to mitigate the clinical and economic consequences of PH-ILD development and progression.
METHODS: A retrospective cohort analysis of the Truven Health MarketScan® Commercial Claims and Encounters Database and Medicare Supplemental Database between June 2015 to June 2019 was conducted. Patients with ILD were identified and indexed based on their first claim with a PH diagnosis. Patients were required to be 18 years of age on the index date and continuously enrolled for 12-months pre- and post-index. Patients were excluded for having a PH diagnosis prior to ILD diagnosis or the presence of other non-ILD, PH-associated conditions. Treatment patterns, HCRU, and healthcare costs were compared between the 12 months pre- versus 12 months post-index date.
RESULTS: In total, 122 patients with PH-ILD were included (mean [SD] age, 63.7 [16.6] years; female, 64.8%). The same medication classes were most frequently used both pre- and post-index (corticosteroids: pre-index 43.4%, post-index 53.5%; calcium channel blockers: 25.4%, 36.9%; oxygen: 12.3%, 25.4%). All-cause hospitalizations increased 2-fold, with 29.5% of patients hospitalized pre-index vs. 59.0% post-index (P < 0.0001). Intensive care unit (ICU) utilization increased from 6.6 to 17.2% (P = 0.0433). Mean inpatient visits increased from 0.5 (SD, 0.9) to 1.1 (1.3) (P < 0.0001); length of stay (days) increased from 5.4 (5.9) to 7.5 (11.6) (P < 0.0001); bed days from 2.5 (6.6) to 8.0 (16.3) (P < 0.0001); ICU days from 3.8 (2.3) to 7.0 (13.2) (P = 0.0362); and outpatient visits from 24.5 (16.8) to 32.9 (21.8) (P < 0.0001). Mean (SD) total all-cause healthcare costs increased from $43,201 ($98,604) pre-index to $108,387 ($190,673) post-index (P < 0.0001); this was largely driven by hospitalizations (which increased from a mean [SD] of $13,133 [$28,752] to $63,218 [$75,639] [P < 0.0001]) and outpatient costs ($16,150 [$75,639] to $25,604 [$93,964] [P < 0.0001]).
CONCLUSIONS: PH-ILD contributes to a high HCRU and cost burden. Timely identification, management, and treatment are needed to mitigate the clinical and economic consequences of PH-ILD development and progression.
摘要：
背景：间质性肺病（PH-ILD）引起的肺动脉高压与呼吸衰竭和死亡率高相关。需要医疗资源利用率（HCRU）和成本数据来表征PH-ILD疾病负担。
方法：对2015年6月至2019年6月的TruvenHealthMarketScan®商业索赔和遭遇数据库和医疗保险补充数据库进行了回顾性队列分析。ILD患者根据其首次诊断为PH的要求进行鉴定和索引。要求患者在指数日期为18岁，并在指数之前和之后连续招募12个月。患者因在ILD诊断之前有PH诊断或存在其他非ILD而被排除在外。与PH相关的条件。治疗模式,HCCU,和医疗费用在索引日期前12个月与索引日期后12个月之间进行了比较.
结果：总计，纳入122例PH-ILD患者(平均[SD]年龄，63.7[16.6]年；女性，64.8%）。指数前和指数后最常用的药物类别是相同的（皮质类固醇：指数前43.4%，后指数53.5%；钙通道阻滞剂：25.4%，36.9%;氧气:12.3%,25.4%）。全因住院增加了2倍,29.5%的患者住院前指数与后指数59.0%(P<0.0001)。重症监护病房（ICU）的利用率从6.6％增加到17.2％（P=0.0433）。平均住院次数从0.5增加(标准差，0.9）至1.1（1.3）（P<0.0001）；住院时间（天数）从5.4（5.9）增加到7.5（11.6）（P<0.0001）；卧床天数从2.5（6.6）增加到8.0（16.3）（P<0.0001）；ICU天数从3.8（2.3）增加到7.0（13.2）（P=0.0362）；门诊量从24.5（16.8）增加到32.9（21.8）（平均（SD）所有原因的医疗总费用从指数前的$43,201（$98,604）增加到指数后的$108,387（$190,673）（P<0.0001）；这主要是由于住院（从平均[SD]$13,133[$28,752]增加到$63,218[$75,639][P<0.0001]$9150）和[$6604]$
结论：PH-ILD导致高HCRU和成本负担。及时识别,管理,需要治疗来减轻PH-ILD发展和进展的临床和经济后果。
方法：对2015年6月至2019年6月的TruvenHealthMarketScan®商业索赔和遭遇数据库和医疗保险补充数据库进行了回顾性队列分析。ILD患者根据其首次诊断为PH的要求进行鉴定和索引。要求患者在指数日期为18岁，并在指数之前和之后连续招募12个月。患者因在ILD诊断之前有PH诊断或存在其他非ILD而被排除在外。与PH相关的条件。治疗模式,HCCU,和医疗费用在索引日期前12个月与索引日期后12个月之间进行了比较.
结果：总计，纳入122例PH-ILD患者(平均[SD]年龄，63.7[16.6]年；女性，64.8%）。指数前和指数后最常用的药物类别是相同的（皮质类固醇：指数前43.4%，后指数53.5%；钙通道阻滞剂：25.4%，36.9%;氧气:12.3%,25.4%）。全因住院增加了2倍,29.5%的患者住院前指数与后指数59.0%(P<0.0001)。重症监护病房（ICU）的利用率从6.6％增加到17.2％（P=0.0433）。平均住院次数从0.5增加(标准差，0.9）至1.1（1.3）（P<0.0001）；住院时间（天数）从5.4（5.9）增加到7.5（11.6）（P<0.0001）；卧床天数从2.5（6.6）增加到8.0（16.3）（P<0.0001）；ICU天数从3.8（2.3）增加到7.0（13.2）（P=0.0362）；门诊量从24.5（16.8）增加到32.9（21.8）（平均（SD）所有原因的医疗总费用从指数前的$43,201（$98,604）增加到指数后的$108,387（$190,673）（P<0.0001）；这主要是由于住院（从平均[SD]$13,133[$28,752]增加到$63,218[$75,639][P<0.0001]$9150）和[$6604]$
结论：PH-ILD导致高HCRU和成本负担。及时识别,管理,需要治疗来减轻PH-ILD发展和进展的临床和经济后果。
