摘要
为了量化多发性骨髓瘤(MM)并发症对直接医疗成本的影响,利用中国医疗保险研究会2013年抽样的城镇职工和居民参保患者的医保数据进行分析,从而获取MM患者的并发症发生率,及其对直接医疗费用的影响。本研究先使用MM的疾病诊断编码在医保数据库中进行检索,共获得522名患者,其中有182名MM并发症患者。分析结果显示,与MM并发症存在独立显著相关性的因素有东部居民、就诊医院为一级及以下、参加城镇居民医保及合并高血压。与无并发症的患者直接无校正比较,患有并发症的患者医疗资源使用和直接医疗成本(药品费、诊疗费、总直接医疗费)显著增加。多因素广义线性模型校正相关医疗费用影响因子后,并发症仍然与药品费、诊疗费及总直接医疗费用存在显著相关性。以上结果证实MM并发症在城镇MM患者中发生普遍,并且显著增加直接医疗成本,提示MM通过早期诊断和早期治疗控制并发症可以达到降低直接医疗费用的目的。
The sampled claim data of insured urban employees and residents collected by China Health Insurance Research Association （CHIRA） in 2013 were retrospectively analyzed to estimate the prevalence of multiple myeloma （MM）-related complications and the direct medical costs on MM-related complications. By searching the claim data using the diagnosis code of MM, we identified 522 patients with diagnosed MM, which included 182 patients with at least one kind of MM-related complications. Multiple logistic regression analysis showed independent and significant association between MM-related complications and urban residency in Eastern China, treated in Class I or below hospitals, having urban resident insurance plan, and comorbidity with hypertension. When compared to MM patients without complications, patients with MM-related complications were associated with significantly higher resource use and costs on out-patient clinic visits, hospital visits, drug costs, non-drug costs, and total direct medical costs. Multiple generalized linear models showed significant impact of MM- related complications on drug costs, non-drug costs, and total direct medical costs after adjusting confounders. Thisretrospective analysis of claims data of China confirmed a high prevalence of complications in MM patients. The significant association between MM-related complications and direct medical costs suggests that early diagnosis and early treatment are likely to reduce direct medical costs associated with MM through controlling MM-related complications
出处
《中国医疗保险》
2016年第1期54-58,共5页
China Health Insurance
