目的:量化接受充气阴茎假体(IPP)治疗勃起功能障碍(ED)的男性的后续治疗所产生的下游收入增量,与没有ED的男人相比。
方法:使用100%Medicare标准分析文件对接受IPP治疗ED的患者产生的5年收入进行回顾性索赔分析,与没有ED的男性倾向匹配队列相比。在2016年1月1日至2021年12月31日期间在医院门诊进行IPP植入(当前程序术语®54405),并且连续进行MedicareA和B部分招募12个月的ED年龄65岁或以上的男性纳入了索引前IPP和索引后IPP出院日期五年的研究。没有ED但具有可比特征的男性被确定并用作比较组。医院从医疗保险获得的收入被定义为病人服务的付款总额,其他付款人支付的金额,患者免赔额,共付额,和共同保险。收入膨胀至2022年美元。报告平均值及其相应的标准偏差(SD)。
结果:匹配后,有2,905名患有ED的男性获得了IPP,有7,462名没有ED的男性。与没有ED的男性(平均=3,189美元[SD=11,527美元])相比,IPP队列显示出明显更高的5年累计收入(平均=34,571美元[SD=50,234美元])。当按诊断类型分层时,循环系统疾病的收入差异为10258美元,2,646美元用于糖尿病,泌尿科$2,013,和1,043美元的前列腺癌。在5年的随访期内,与对照组相比,明显更多的IPP患者至少有一次针对这些疾病的健康遭遇(55.0%对7.8%的循环系统,46.7%对泌尿外科的16.8%,19.3%对糖尿病的3.6%,前列腺癌为19.0%和3.0%)。
结论:接受IPP的ED男性在5年内为医疗保健系统带来了更高的收入,差不多十倍,与没有ED的男人相比,不包括IPP程序的初始成本。ED的存在,再加上IPP的使用,与没有ED的男性相比,在一系列医疗条件下,医疗保健收入显着增加。这些发现强调了高级ED计划的财务影响,以改善这些患者获得必要护理的机会。医疗机构可以利用这些见解来有效地分配资源,为患有ED的男性提供关键的医疗保健。
OBJECTIVE: To quantify the incremental downstream revenue generated from subsequent treatment of men who received an inflatable penile prosthesis (IPP) to treat erectile dysfunction (ED), compared to men without ED.
METHODS: The 100% Medicare Standard Analytic Files were used to conduct a retrospective claims analysis of the 5-year revenue generated by patients receiving IPP to treat their ED, compared to a propensity-matched cohort of men without ED. Men aged 65 years or older with ED who underwent IPP implantation (Current Procedural Terminology 54405) in a hospital outpatient setting between January 1, 2016 and December 31, 2021, and who had continuous Medicare Parts A and B enrollment for 12 months pre-index IPP and 5 years post-index IPP discharge date were included in the study. Men without ED but with comparable characteristics were identified and used as a comparator group. Revenue received by hospitals from Medicare was defined as the sum of payments for patient services, other payor-paid amounts, patient deductibles, copayments, and coinsurance. Revenue was inflated to 2022 US dollars. The mean values and their corresponding standard deviations (SD) are reported.
RESULTS: After matching, there were 2905 men with ED who received an IPP and 7462 men without ED. The IPP cohort showed a significantly higher 5-year cumulative revenue (mean=$34,571 [SD=$50,234]) compared to the men without ED (mean=$3189 [SD=$11,527]). When stratified by diagnosis type, the differences in revenue were $10,258 for circulatory disease, $2646 for diabetes, $2013 for urology, and $1043 for prostate cancer. Significantly more IPP patients had at least 1 health encounter for these conditions over the 5-year follow-up period than their matched controls (55.0% vs 7.8% for circulatory, 46.7% vs 16.8% for urology, 19.3% vs 3.6% for diabetes, and 19.0% vs 3.0% for prostate cancer).
CONCLUSIONS: Men with ED who received IPP generated substantially higher revenue for the healthcare system over a 5-year period, nearly 10 times as much, compared to men without ED, excluding the initial cost of the IPP procedure. The presence of ED, coupled with IPP usage, is associated with significantly increased healthcare revenue across a range of medical conditions compared to men without ED. These findings emphasize the financial implications for advanced ED programs to improve access to necessary care for these patients. Healthcare facilities may leverage these insights to effectively allocate resources to deliver critical healthcare to men with ED.