美国哮喘或慢阻肺人群中确诊患有百日咳患者的经济负担：一项源于管理性申报数据库的研究
2017/10/09
摘要
患有慢性呼吸系统疾病的人群具有较高的百日咳罹患风险。我们使用管理性申报数据库进行回顾性研究分析，以探讨在患有哮喘或慢阻肺（COPD）的美国青少年或成人人群中，百日咳的发病率以及其所造成的经济负担。
将年龄≥11岁、既已患有COPD (n = 343)或哮喘(n = 1041)的百日咳病人与那些未患有COPD或哮喘的百日咳病人按照1:1的比例进行匹配。在百日咳索引日期前后的45天、3个月和6个月内，计算全因费用的差异（额外费用）；通过多元回归模型计算调整后的额外费用。
在COPD或哮喘患者中，百日咳的发病率要高于相对应的匹配组。与匹配组相比较，既已患有COPD或哮喘的百日咳病人在研究期间具有更高的全因调整费用。（在45天内，分别额外花费了3694 和 1193美元；在3个月内，分别额外花费了4173 和1301美元；在6个月内，分别额外花费了6154和1639美元，P均< 0.0001）。既往患有COPD或哮喘的患者在确诊百日咳后将承担更重的经济负担，百白破三联疫苗（百日咳、白喉、破伤风混合疫苗）可能对这一类患者具有特别的益处。
Economic burden of diagnosed pertussis among individuals with asthma or chronic obstructive pulmonary disease in the USA: an analysis of administrative claims.
Buck PO, Meyers JL, Gordon LD, Parikh R, Kurosky SK, Davis KL.
Abstract
Individuals with chronic respiratory conditions may be at increased risk for pertussis. We conducted a retrospective administrative claims analysis to examine the incidence and economic burden of diagnosed pertussis among adolescents and adults in the USA with chronic obstructive pulmonary disease (COPD) or asthma. Patients aged ⩾11 years with diagnosed pertussis and pre-existing COPD (n = 343) or asthma (n = 1041) were matched 1:1 to patients with diagnosed pertussis but without COPD or asthma. Differences in all-cause costs ('excess' costs) during the 45-day and 3-month and 6-month periods before and after the pertussis index date were calculated; adjusted excess costs were estimated via multivariate regressions.
The incidence of diagnosed pertussis was higher among patients with COPD or asthma than among matched patients. Compared with matched patients, patients with pertussis and pre-existing COPD or asthma accrued greater all-cause adjusted costs across study periods ($3694 and $1193 more, respectively, in the 45-day period; $4173 and $1301 more in the 3-month period; and $6154 and $1639 more in the 6-month period; all P < 0•0001). Patients with pre-existing COPD or asthma experience an increased economic burden after diagnosed pertussis and may especially benefit from targeted tetanus, diphtheria, and acellular pertussis vaccination strategies.
患有慢性呼吸系统疾病的人群具有较高的百日咳罹患风险。我们使用管理性申报数据库进行回顾性研究分析，以探讨在患有哮喘或慢阻肺（COPD）的美国青少年或成人人群中，百日咳的发病率以及其所造成的经济负担。
将年龄≥11岁、既已患有COPD (n = 343)或哮喘(n = 1041)的百日咳病人与那些未患有COPD或哮喘的百日咳病人按照1:1的比例进行匹配。在百日咳索引日期前后的45天、3个月和6个月内，计算全因费用的差异（额外费用）；通过多元回归模型计算调整后的额外费用。
在COPD或哮喘患者中，百日咳的发病率要高于相对应的匹配组。与匹配组相比较，既已患有COPD或哮喘的百日咳病人在研究期间具有更高的全因调整费用。（在45天内，分别额外花费了3694 和 1193美元；在3个月内，分别额外花费了4173 和1301美元；在6个月内，分别额外花费了6154和1639美元，P均< 0.0001）。既往患有COPD或哮喘的患者在确诊百日咳后将承担更重的经济负担，百白破三联疫苗（百日咳、白喉、破伤风混合疫苗）可能对这一类患者具有特别的益处。
（复旦大学附属中山医院呼吸内科 胡湘麟 摘译 杨 冬 审校）
（Epidemiol Infect. 2017 Jul;145(10):2109-2121. ）
（Epidemiol Infect. 2017 Jul;145(10):2109-2121. ）
Economic burden of diagnosed pertussis among individuals with asthma or chronic obstructive pulmonary disease in the USA: an analysis of administrative claims.
Buck PO, Meyers JL, Gordon LD, Parikh R, Kurosky SK, Davis KL.
Abstract
Individuals with chronic respiratory conditions may be at increased risk for pertussis. We conducted a retrospective administrative claims analysis to examine the incidence and economic burden of diagnosed pertussis among adolescents and adults in the USA with chronic obstructive pulmonary disease (COPD) or asthma. Patients aged ⩾11 years with diagnosed pertussis and pre-existing COPD (n = 343) or asthma (n = 1041) were matched 1:1 to patients with diagnosed pertussis but without COPD or asthma. Differences in all-cause costs ('excess' costs) during the 45-day and 3-month and 6-month periods before and after the pertussis index date were calculated; adjusted excess costs were estimated via multivariate regressions.
The incidence of diagnosed pertussis was higher among patients with COPD or asthma than among matched patients. Compared with matched patients, patients with pertussis and pre-existing COPD or asthma accrued greater all-cause adjusted costs across study periods ($3694 and $1193 more, respectively, in the 45-day period; $4173 and $1301 more in the 3-month period; and $6154 and $1639 more in the 6-month period; all P < 0•0001). Patients with pre-existing COPD or asthma experience an increased economic burden after diagnosed pertussis and may especially benefit from targeted tetanus, diphtheria, and acellular pertussis vaccination strategies.
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“我失去了生活的方方面面”：严重哮喘的隐性负担
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自动筛查哮喘和慢性阻塞性肺病的移动平台
