Economic Burden of Delayed Diagnosis in Patients with Pulmonary Arterial Hypertension (PAH).

IF 2 Q2 ECONOMICS

PharmacoEconomics Open Pub Date : 2024-01-01 Epub Date: 2023-11-18 DOI:10.1007/s41669-023-00453-8

Hilary M DuBrock, Hayley D Germack, Marjolaine Gauthier-Loiselle, Jörg Linder, Ambika Satija, Ameur M Manceur, Martin Cloutier, Patrick Lefebvre, Sumeet Panjabi, Robert P Frantz

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引用次数: 0

Abstract

Background: The aim of this study was to assess health care resource utilization (HRU) and costs associated with delayed pulmonary arterial hypertension (PAH) diagnosis in the United States.

Methods: Eligible adults with newly diagnosed PAH from Optum's de-identified Clinformatics^® Data Mart Database (2016-2021) were assigned to mutually exclusive cohorts based on time between first PAH-related symptom and first PAH diagnosis (i.e., ≤12 months' delay, >12 to ≤24 months' delay, >24 months' delay). All-cause HRU and health care costs per patient per month (PPPM) were assessed during the first year following diagnosis and compared across cohorts using regression analysis adjusted for baseline covariates. Sensitivity analyses were conducted to assess outcomes during all available follow-up post-diagnosis.

Results: Among 538 patients (mean age: 65.6 years; 60.6% female), 60.8% had ≤12 months' delay, 23.4% had a delay of >12 to ≤24 months, and 15.8% had >24 months' delay. Compared with ≤12 months, delays of >12 to ≤24 months and >24 months were associated with increased hospitalizations (incidence rate ratio [95% confidence interval]: 1.40 [1.11-1.71] vs 1.71 [1.29-2.12]) and outpatient visits (1.17 [1.06-1.30] vs 1.26 [1.08-1.41]). Longer delays were also associated with more intensive care unit (ICU) stays and 30-day readmissions. Diagnosis delays translated into excess costs PPPM of US$3986 [1439-6436] for >12 to ≤24 months and US$5366 [2107-8524] for >24 months compared with ≤12 months' delay; increased hospitalization costs (US$3248 [1108-5135] and US$4048 [1401-6342], respectively) being the driver. Sensitivity analyses yielded similar trends.

Conclusions: Delayed PAH diagnosis is associated with significant incremental economic burden post-diagnosis, driven by hospitalizations including ICU stays and 30-day readmissions, highlighting the need for increased awareness and a potential benefit of earlier screening.

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肺动脉高压(PAH)患者延迟诊断的经济负担。

背景:本研究的目的是评估美国迟发性肺动脉高压(PAH)诊断相关的医疗资源利用率(HRU)和成本。方法:根据首次PAH相关症状与首次PAH诊断之间的时间(即延迟≤12个月，>延迟12至≤24个月，>延迟24个月)，将来自Optum的去识别Clinformatics®数据市场数据库(2016-2021)的新诊断PAH的符合条件的成人分配到相互排斥的队列。在诊断后的第一年评估全因HRU和每个患者每月的医疗保健费用(PPPM)，并使用基线协变量调整的回归分析进行跨队列比较。进行敏感性分析以评估诊断后所有可用随访期间的结果。结果:538例患者(平均年龄65.6岁;60.6%为女性)，延迟≤12个月的占60.8%，延迟12 ~≤24个月的占23.4%，延迟24个月的占15.8%。与≤12个月相比，>延迟12至≤24个月和>延迟24个月与住院次数增加(发病率比[95%可信区间]:1.40 [1.11-1.71]vs 1.71[1.29-2.12])和门诊次数增加(1.17 [1.06-1.30]vs 1.26[1.08-1.41])相关。更长的延误也与更多的重症监护病房(ICU)停留和30天的再入院有关。与≤12个月的延迟相比，诊断延迟导致bb0 12至≤24个月的PPPM额外成本为3986美元[1439-6436]，bb1 24个月的PPPM额外成本为5366美元[2107-8524];住院费用增加(分别为3248美元[1108-5135]和4048美元[1401-6342])是驱动因素。敏感性分析得出了类似的趋势。结论:PAH诊断延迟与诊断后经济负担显著增加相关，住院包括ICU住院和30天再入院，强调需要提高认识和早期筛查的潜在益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PharmacoEconomics Open Multiple-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.