Cargando…

Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S.

Non-cystic fibrosis bronchiectasis (NCFBE) is a rare, chronic lung disease characterized by bronchial inflammation and permanent airway dilation. Chronic infections with P. aeruginosa have been linked to higher morbidity and mortality. To understand the impact of P. aeruginosa in NCFBE on health car...

Descripción completa

Detalles Bibliográficos
Autores principales: Blanchette, Christopher M., Noone, Joshua M., Stone, Glenda, Zacherle, Emily, Patel, Ripsi P., Howden, Reuben, Mapel, Douglas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753649/
https://www.ncbi.nlm.nih.gov/pubmed/29099036
http://dx.doi.org/10.3390/medsci5040020
_version_ 1783290311569571840
author Blanchette, Christopher M.
Noone, Joshua M.
Stone, Glenda
Zacherle, Emily
Patel, Ripsi P.
Howden, Reuben
Mapel, Douglas
author_facet Blanchette, Christopher M.
Noone, Joshua M.
Stone, Glenda
Zacherle, Emily
Patel, Ripsi P.
Howden, Reuben
Mapel, Douglas
author_sort Blanchette, Christopher M.
collection PubMed
description Non-cystic fibrosis bronchiectasis (NCFBE) is a rare, chronic lung disease characterized by bronchial inflammation and permanent airway dilation. Chronic infections with P. aeruginosa have been linked to higher morbidity and mortality. To understand the impact of P. aeruginosa in NCFBE on health care costs and burden, we assessed healthcare costs and utilization before and after P. aeruginosa diagnosis. Using data from 2007 to 2013 PharMetrics Plus administrative claims, we included patients with ≥2 claims for bronchiectasis and >1 claim for P. aeruginosa; then excluded those with a claim for cystic fibrosis. Patients were indexed at first claim for P. aeruginosa and were required to have >12 months before and after the index P. aeruginosa. The mean differences in utilization and costs were assessed using paired Student’s t-tests for statistical significance. Mean total healthcare costs per patient were $36,213 pre-P. aeruginosa diagnosis versus $67,764 post-P. aeruginosa, an increase of 87% (p < 0.0001). Inpatient costs represented the largest proportion of total healthcare costs post-P. aeruginosa (54%) with an increase of four hospitalizations per patient (p < 0.0001). NCFBE patients with evidence of P. aeruginosa incur substantially greater healthcare costs and utilization after P. aeruginosa diagnosis. Future research should explore methods of earlier identification of NCFBE patients with P. aeruginosa, as this may lead to fewer severe exacerbations, thereby resulting in a reduction in hospitalizations and healthcare costs.
format Online
Article
Text
id pubmed-5753649
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-57536492018-01-08 Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S. Blanchette, Christopher M. Noone, Joshua M. Stone, Glenda Zacherle, Emily Patel, Ripsi P. Howden, Reuben Mapel, Douglas Med Sci (Basel) Article Non-cystic fibrosis bronchiectasis (NCFBE) is a rare, chronic lung disease characterized by bronchial inflammation and permanent airway dilation. Chronic infections with P. aeruginosa have been linked to higher morbidity and mortality. To understand the impact of P. aeruginosa in NCFBE on health care costs and burden, we assessed healthcare costs and utilization before and after P. aeruginosa diagnosis. Using data from 2007 to 2013 PharMetrics Plus administrative claims, we included patients with ≥2 claims for bronchiectasis and >1 claim for P. aeruginosa; then excluded those with a claim for cystic fibrosis. Patients were indexed at first claim for P. aeruginosa and were required to have >12 months before and after the index P. aeruginosa. The mean differences in utilization and costs were assessed using paired Student’s t-tests for statistical significance. Mean total healthcare costs per patient were $36,213 pre-P. aeruginosa diagnosis versus $67,764 post-P. aeruginosa, an increase of 87% (p < 0.0001). Inpatient costs represented the largest proportion of total healthcare costs post-P. aeruginosa (54%) with an increase of four hospitalizations per patient (p < 0.0001). NCFBE patients with evidence of P. aeruginosa incur substantially greater healthcare costs and utilization after P. aeruginosa diagnosis. Future research should explore methods of earlier identification of NCFBE patients with P. aeruginosa, as this may lead to fewer severe exacerbations, thereby resulting in a reduction in hospitalizations and healthcare costs. MDPI 2017-09-23 /pmc/articles/PMC5753649/ /pubmed/29099036 http://dx.doi.org/10.3390/medsci5040020 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Blanchette, Christopher M.
Noone, Joshua M.
Stone, Glenda
Zacherle, Emily
Patel, Ripsi P.
Howden, Reuben
Mapel, Douglas
Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S.
title Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S.
title_full Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S.
title_fullStr Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S.
title_full_unstemmed Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S.
title_short Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S.
title_sort healthcare cost and utilization before and after diagnosis of pseudomonas aeruginosa among patients with non-cystic fibrosis bronchiectasis in the u.s.
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753649/
https://www.ncbi.nlm.nih.gov/pubmed/29099036
http://dx.doi.org/10.3390/medsci5040020
work_keys_str_mv AT blanchettechristopherm healthcarecostandutilizationbeforeandafterdiagnosisofpseudomonasaeruginosaamongpatientswithnoncysticfibrosisbronchiectasisintheus
AT noonejoshuam healthcarecostandutilizationbeforeandafterdiagnosisofpseudomonasaeruginosaamongpatientswithnoncysticfibrosisbronchiectasisintheus
AT stoneglenda healthcarecostandutilizationbeforeandafterdiagnosisofpseudomonasaeruginosaamongpatientswithnoncysticfibrosisbronchiectasisintheus
AT zacherleemily healthcarecostandutilizationbeforeandafterdiagnosisofpseudomonasaeruginosaamongpatientswithnoncysticfibrosisbronchiectasisintheus
AT patelripsip healthcarecostandutilizationbeforeandafterdiagnosisofpseudomonasaeruginosaamongpatientswithnoncysticfibrosisbronchiectasisintheus
AT howdenreuben healthcarecostandutilizationbeforeandafterdiagnosisofpseudomonasaeruginosaamongpatientswithnoncysticfibrosisbronchiectasisintheus
AT mapeldouglas healthcarecostandutilizationbeforeandafterdiagnosisofpseudomonasaeruginosaamongpatientswithnoncysticfibrosisbronchiectasisintheus