Healthcare and economic impact of diarrhea in patients with carcinoid syndrome

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:GWstars
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
AIM: To examine healthcare resource utilization patterns and costs accrued by carcinoid syndrome(CS) patients with and without diarrhea.METHODS: We conducted a retrospective cohort study using Market Scan~® data from 1/1/2002-12/31/2012. Newly diagnosed CS patients had 1 medical claim for CS(ICD-9-CM code 259.2) plus either ≥ 1 additional claim for CS or for carcinoid tumors(ICD-9-CM 209.x), and had no evidence of CS for 1 year prior to index CS diagnosis, in commercially-insured patients < 65 years old. Patients were required to have continuous enrollment one year prior and after index date(first claim with CS diagnosis in the ID period). We identified patients with evidence of non-infectious diarrhea(ICD-9-CM codes 564.5 and 787.91) within one year from the index date. Overall and CS-related healthcare resource utilization and costs were compared between patients with and without non-infectious diarrhea during the one year period after the index date. RESULTS: There were 2822 newly diagnosed CS patients; 534(18.9%) had evidence of non-infectious diarrhea. Compared to patients without non-infectious diarrhea, non-infectious diarrhea patients more commonly had at ≥ 1 CS-related hospitalization(13.7% vs 7.2%), ≥ 1 CS-related ED visit(11.0% vs 4.4%), and CS-related office visits in one year(6.9 vs 4.1; all P < 0.001). After adjusting for demographics, region, number of chronic conditions and the Charlson Comorbidity Index, the proportions of patients with any and with CS-related hospitalizations were 9.7% and 6.8% higher, respectively, among non-infectious diarrhea patients compared to those with without noninfectious diarrhea(P < 0.001). Unadjusted costs were significantly higher among non-infectious diarrhea patients vs those without non-infectious diarrhea. The non-infectious diarrhea group was also more costly, with adjusted mean annual costs of $81610, compared to $51719 in the group without non-infectious diarrhea(P < 0.001). CONCLUSION: Diarrhea is burdensome and costly in CS patients. Reduction of CS-related healthcare expenditures may be achievable through preventive treatment and appropriate management of diarrhea in CS. AIM: To examine healthcare resource utilization patterns and costs accrued by carcinoid syndrome (CS) patients with and without diarrhea. METHODS: We conducted a retrospective cohort study using Market Scan® data from 1/1/2002-12 / 31/2012. Newly diagnosed CS patients had a medical claim for CS (ICD-9-CM code 259.2) plus either ≥ 1 additional claim for CS or for carcinoid tumors (ICD-9-CM 209.x), and had no evidence of CS for 1 year prior to index CS diagnosis, in commercially-insured patients <65 years old. Patients were required to have continuous enrollment one year prior and after index date (first claim with CS diagnosis in the ID period). -infectious diarrhea (ICD-9-CM codes 564.5 and 787.91) within one year from the index date. Overall and CS-related healthcare resource utilization and costs were compared between patients with and without non-infectious diarrhea during the one year period after the index date. RESULTS: There were 2822 newl Compared to patients without non-infectious diarrhea, non-infectious diarrhea patients more often had at ≥ 1 CS-related hospitalization (13.7% vs 7.2%), ≥1 CS-related ED visit (11.0% vs 4.4%), and CS-related office visits in one year (6.9 vs 4.1; all P <0.001). After adjusting for demographics, region, number of chronic conditions and the Charlson Comorbidity Index, the proportions of patients with any and with CS-related hospitalizations were 9.7% and 6.8% higher, respectively, among non-infectious diarrhea patients compared to those with non noninfectious diarrhea (P <0.001). Unadjusted costs were significantly higher among non -infectious diarrhea patients vs those without non-infectious diarrhea. The non-infectious diarrhea group was also more costly, with adjusted mean annual costs of $ 81610, compared to $ 51719 in the group without non-infectious diarrhea. (CONCLUSION: Diarrhea is burde nsome and costly in CS patients. Reduction of CS-related healthcare expenditures may be achievable through preventive treatment and appropriate management of diarrhea in CS.
其他文献
《风车转转转》,越转越好看,转到2000年“六一”,在鞠萍姐姐和董浩叔叔的旁边,又多了一个做什么事都马马虎虎的家伙,他会带着孩子们满世界跑。奇思妙想《芝麻开门》,你猜猜
目的:观察透刺配合火疗治疗风寒湿型肩周炎的临床疗效.方法:将80例风寒湿型肩周炎患者随机分为2组各40例,治疗组以透刺配合火疗的方法治疗,对照组以单纯体针针刺的方法治疗治
目的:探讨基层医院老年性骨颈骨折患者术后预防褥疮的护理方法及效果.方法:选取老年性股骨颈骨折患者80例作为研究对象,随机分为观察组和对照组,每组40例,对照组患者采取常规
青花作为陶瓷的一种装饰,它是陶瓷生产发展到一定历史阶段的产物。陶瓷所承载的文化,内容丰富、形式多样,它所体现的文化功能从物质到非物质比比皆是。而青花作为陶瓷装饰起
目的:观察护理在新生儿肺炎中的疗效.方法:收治肺炎新生患儿60例,观察组在常规治疗的基础上同时给予积极的护理.结果:通过实施综合护理,60例患儿中治愈59例,死亡1例,总治愈率
脱落细胞学是国内和国际基层医院传统的妇科子宫颈炎症,癌前病变和恶性肿瘤常规筛查的手段之一.在更长时间以来,这种手段发挥了它的巨大作用.但是这种手段检查者思路着重肿瘤
秘书工作的思维形式表现为全局性思维、换位思维、超前思维、创造性思维和逻辑思维等。本文就换位思维,谈一点认识。 一、秘书思维活动上升到领导者层次 秘书思维活动换位到
目的:分析中医辩证护理对急性阑尾炎患者护理的影响.方法:依照接收顺序,把我院的98例急性阑尾炎患者分成两组,每组49人,在两组患者都进行对症保守治疗的基础上,一组采用常规
目的:探讨股骨头缺血性坏死患者髋关节置换术后的护理方式.方法:回顾性分析2010年1月-2012年6月我院收治的60例股骨头缺血性坏死患者的临床资料,60例患者均经过髋关节置换术
产后抑郁是常见的情感精神障碍.以产后困倦、流泪、哭泣等为特征,不仅影响到心身还对婴儿的情感产生影响,因此心理护理提供对产妇,婴儿周全的照顾,避免对产妇的不良精神刺激,