Health Care Resource Use and Costs Among Patients with Cushing Disease |
| |
| Affiliation: | 1. Neuroendocrine Clinical Center, Massachusetts General Hospital, Boston, Massachusetts;2. United BioSource Corporation, Lexington, Massachusetts;3. Novartis Pharmaceuticals, Florham Park, New, Jersey.;1. Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;2. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;3. Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;4. Neuroscience Center of Chinese Academy of Medical Sciences, Beijing, PR China;1. NeuroSpine Surgery Research Group (NSURG), Suite 7a, Level 7, Prince of Wales Private Hospital, Sydney, Barker St, Randwick, New South Wales 2031, Australia;2. Faculty of Medicine, University of New South Wales (UNSW), Gate 2, High St, Kensington, New South Wales 2033, Australia;3. Department of Orthopaedic Surgery at Mount Sinai, 5 East 98th St, Box 1188, New York, NY 10029, USA;1. Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA;2. Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA;3. Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA;4. Rhinology Section, North Shore University Hospital, Manhasset, NY, USA;5. Department of Otolaryngology, New York University School of Medicine, New York, NY, USA |
| |
| Abstract: | ObjectiveTo assess health care costs associated with Cushing disease and to determine changes in overall and comorbidity-related costs after surgical treatment.MethodsIn this retrospective cohort study, patients with Cushing disease were identified from insurance claims databases by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes for Cushing syndrome (255.0) and either benign pituitary adenomas (227.3) or hypophysectomy (07.6x) between 2004 and 2008. Each patient with Cushing disease was age- and sex-matched with 4 patients with nonfunctioning pituitary adenomas and 10 population control subjects. Comorbid conditions and annual direct health care costs were assessed within each calendar year. Postoperative changes in health care costs and comorbidity-related costs were compared between patients presumed to be in remission and those with presumed persistent disease.ResultsOf 877 identified patients with Cushing disease, 79% were female and the average age was 43.4 years. Hypertension, diabetes mellitus, and hyperlipidemia were more common among patients with Cushing disease than in patients with nonfunctioning pituitary adenomas or in control patients (P < .01). For every calendar year studied, patients with Cushing disease had significantly higher total health care costs (2008: $26440 [Cushing disease] vs $13 708 [nonfunctioning pituitary adenomas] vs $5954 [population control], P < .01). Annual outpatient costs decreased significantly for patients in remission after surgery, and there was a trend towards improvement in overall disease-related costs with remission. A significant increase in postoperative health care costs was observed in those patients not in remission.ConclusionsPatients with Cushing disease had more comorbidities than patients with nonfunctioning pituitary adenomas or control patients and incurred significantly higher annual health care costs; these costs decreased after successful surgery and increased after unsuccessful surgery. (Endocr Pract. 2011;17:681-690) |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
