支气管扩张带来了巨大的经济负担,与频繁住院相关的高医疗保健支出,医生访问,和治疗,包括口服和静脉注射抗生素治疗反复肺部感染,气道清除疗法,和氧气管理。支气管扩张恶化可能导致这种负担。
■评估与支气管扩张和支气管扩张恶化相关的美国医疗保健资源利用率(HCRU)和成本。
这项回顾性研究使用100%Medicare按服务收费数据库(2014年1月至2020年12月)比较了支气管扩张患者与无支气管扩张患者(对照)的HCRU和费用。对于支气管扩张患者,索引日期是在超过1年的疾病史之后随机选择的支气管扩张声称,对于控件,最接近他们匹配的支气管扩张患者索引日期的索赔。所有患者连续入组至少12个月的预指数(基线)和至少12个月的后指数。主要结果是全因,与呼吸有关的,与支气管扩张相关的HCCU和医疗保健费用,通过总体样本和基于基线期间加重次数(0,1或≥2)的分段患者队列来呈现.
■92,529例支气管扩张患者(平均[SD]年龄,76.7[8.8]岁;72.3%为女性)和92,529名匹配的对照合格。与对照组相比,支气管扩张患者的全因就诊次数(15.4[10.0]vs13.2[9.7];P<0.001)和与呼吸相关的就诊次数(5.2[4.3]vs1.9[3.1])平均(SD)更大,肺科医师就诊(1.9[2.2]对0.3[1.0]),住院(0.4[0.9]对0.3[0.8]),急诊科就诊(0.33[1.0]vs0.26[1.0]),和总医疗保健费用(10,224美元[23,263美元]对6,704美元[19,593美元])。在基线加重较多的患者中,与呼吸相关的HCRU也更高。对于0、1和至少2次加重的患者,总医疗保健费用为8,506美元,10,365美元和14,790美元,分别为(P<0.01)。
这项现实世界的研究表明,与支气管扩张和恶化相关的高疾病负担,强调需要改善管理和减少恶化。
UNASSIGNED: Bronchiectasis carries a significant economic burden with high health care expenditures associated with frequent hospitalizations, physician visits, and treatments, including oral and intravenous antibiotics for repeated lung infections, airway-clearance therapy, and oxygen administration. Bronchiectasis exacerbations can contribute to this burden.
UNASSIGNED: To estimate US health care resource utilization (HCRU) and costs associated with bronchiectasis and with bronchiectasis exacerbations.
UNASSIGNED: This retrospective study used the 100% Medicare Fee-for-Service database (January 2014 to December 2020) to compare HCRU and costs among patients with bronchiectasis with those of patients without bronchiectasis (controls). For patients with bronchiectasis, the index date was a randomly selected bronchiectasis claim after more than 1 year of disease history and, for controls, a claim closest to their matched bronchiectasis patient\'s index date. All patients had continuous enrollment for at least 12 months pre-index (baseline) and at least 12 months post-index. Primary outcomes were all-cause, respiratory-related, and bronchiectasis-related HCRU and health care costs, which were presented by the overall sample and by segmented patient cohorts based on the number of exacerbations during baseline (0, 1, or ≥2).
UNASSIGNED: 92,529 patients with bronchiectasis (mean [SD] age, 76.7 [8.8] years; 72.3% female) and 92,529 matched controls qualified for the study. Compared with controls, patients with bronchiectasis presented greater mean (SD) all-cause physician visits (15.4 [10.0] vs 13.2 [9.7]; P < 0.001) and respiratory-related physician visits (5.2 [4.3] vs 1.9 [3.1]), pulmonologist visits (1.9 [2.2] vs 0.3 [1.0]), hospitalizations (0.4 [0.9] vs 0.3 [0.8]), emergency department visits (0.33 [1.0] vs 0.26 [1.0]), and total health care costs ($10,224 [$23,263] vs $6,704 [$19,593]). Respiratory-related HCRU was also greater in patients with more baseline exacerbations, with total health care costs of $8,506, $10,365, and $14,790 for patients with 0, 1, and at least 2 exacerbations, respectively (P < 0.01).
UNASSIGNED: This real-world study demonstrates the high disease burden associated with bronchiectasis and with exacerbations, highlighting the need to improve management and reduce exacerbations.