目的:比较成本,医疗保健利用,以及皮肤和血清特异性IgE(sIgE)过敏测试之间的结果。方法:这项回顾性队列研究使用IBM®MarketScan索赔数据,纳入了在2018年1月1日至12月31日期间启动过敏检测的商业保险人群,在指数检测日期前后有至少12个月的入组数据.每位患者的过敏测试费用是根据测试模式估算的:仅皮肤,只有sIgE,或者两者兼而有之。多变量线性回归用于比较医疗保健利用率和结果,包括办公室访问,过敏和哮喘相关的处方,以及在测试后1年的皮肤和sIgE测试之间的急诊科(ED)和紧急护理(UR)访问(α=0.05)。结果:该队列包括168,862例患者,平均(SD)年龄为30.8(19.5)岁;100,666(59.7%)为女性。超过一半的患者(56.4%,n=95,179)只进行皮肤测试,其次是仅进行sIgE检测的57,291例患者和进行两种检测的16,212例患者。在仅进行皮肤测试的患者中,第一年每人的平均过敏测试费用为430美元(95%CI为426-433美元),仅进行sIgE检测的患者为$187(95%CI$183-190),和$532(95%CI$522-542)在两个测试的患者。在1年的随访后测试中,过敏和哮喘相关处方略有增加,所有组的ED访视率显着下降17.0-17.4%,UR访视率显着下降10.9-12.6%(均p<0.01)。在1年的随访中,仅进行sIgE测试的患者比进行皮肤测试的患者少3.2次变态反应者/免疫学家访问(p<0.001)。他们的医疗保健利用和结果在其他方面具有可比性。结论:过敏测试,无论使用哪种测试方法,与1年随访时ED和UR访视减少有关。sIgE过敏测试与较低的测试成本和较少的过敏/免疫学家访问相关,与皮肤测试相比。
UNASSIGNED: To compare the cost, healthcare utilization, and outcomes between skin and serum-specific IgE (sIgE) allergy testing.
UNASSIGNED: This retrospective cohort study used IBM® MarketScan claims data, from which commercially insured individuals who initiated allergy testing between January 1 and December 31, 2018 with at least 12 months of enrollment data before and after index testing date were included. Cost of allergy testing per patient was estimated by testing pattern: skin only, sIgE only, or both. Multivariable linear regression was used to compare healthcare utilization and outcomes, including office visits, allergy and asthma-related prescriptions, and emergency department (ED) and urgent care (UC) visits between skin and sIgE testing at 1-year post testing (α = 0.05).
UNASSIGNED: The cohort included 168,862 patients, with a mean (SD) age of 30.8 (19.5) years; 100,666 (59.7%) were female. Over half of patients (56.4%, n = 95,179) had skin only testing, followed by 57,291 patients with sIgE only testing and 16,212 patients with both testing. The average cost of allergy testing per person in the first year was $430 (95% CI $426-433) in patients with skin only testing, $187 (95% CI $183-190) in patients with sIgE only testing, and $532 (95% CI $522-542) in patients with both testing. At 1-year follow-up post testing, there were slight increases in allergy and asthma-related prescriptions, and notable decreases in ED visits by 17.0-17.4% and in UC visits by 10.9-12.6% for all groups (all p < 0.01). Patients with sIgE-only testing had 3.2 fewer allergist/immunologist visits than patients with skin-only testing at 1-year follow-up (p < 0.001). Their healthcare utilization and outcomes were otherwise comparable.
UNASSIGNED: Allergy testing, regardless of the testing method used, is associated with decreases in ED and UC visits at 1-year follow-up. sIgE allergy testing is associated with lower testing cost and fewer allergist/immunologist visits, compared to skin testing.