Journal of the American Medical Directors Association · 2020
Direct Medical Costs of Dementia With Lewy Bodies by Disease Complexity.
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Espinosa Robert, Davis Matthew, Johnson Scott, Cline Stephanie, Weintraub Daniel
Аннотация
OBJECTIVES: There is currently no accurate profile of the economic burden of dementia with Lewy bodies (DLB), particularly any examination of the direct medical costs of DLB by the number of affected clinical domains. Understanding how trends in the use of healthcare resources evolve as DLB progresses presents opportunities for the development of earlier and more appropriate interventions.
DESIGN: Retrospective study using claims data extracted from the IBM MarketScan Commercial and Medicare Supplemental database.
SETTING AND PARTICIPANTS: In total, 536 patients with DLB from the Commercial database and 5485 patients with DLB from the Medicare Supplemental database.
METHODS: Patients were grouped into disease complexity categories based on core clinical features (ie, fluctuating cognition, motor symptoms, visual hallucinations, and rapid eye movement sleep behavior disorder in addition to dementia) observed during the study period: dementia with no core features observed, dementia plus 1, 2, or ≥3 core features, respectively. Outcome measures included healthcare resource utilization and healthcare costs.
RESULTS: In both databases, total healthcare resource utilization and costs increased with number of core features. Compared with patients with no core features observed, patients in all other complexity categories had significantly higher mean medical visits and costs in both adjusted and unadjusted analyses. Fluctuating cognition was associated with the highest total costs, suggesting that this clinical feature in particular is associated with a considerable economic burden.
CONCLUSIONS AND IMPLICATIONS: Analyzing direct medical costs of DLB by disease complexity using claims data showed that a higher cost impact was associated with increasing number of clinical domains affected and with specific clinical domains, suggesting the need for both targeted and comprehensive interventions to improve the overall economic burden of DLB.
DESIGN: Retrospective study using claims data extracted from the IBM MarketScan Commercial and Medicare Supplemental database.
SETTING AND PARTICIPANTS: In total, 536 patients with DLB from the Commercial database and 5485 patients with DLB from the Medicare Supplemental database.
METHODS: Patients were grouped into disease complexity categories based on core clinical features (ie, fluctuating cognition, motor symptoms, visual hallucinations, and rapid eye movement sleep behavior disorder in addition to dementia) observed during the study period: dementia with no core features observed, dementia plus 1, 2, or ≥3 core features, respectively. Outcome measures included healthcare resource utilization and healthcare costs.
RESULTS: In both databases, total healthcare resource utilization and costs increased with number of core features. Compared with patients with no core features observed, patients in all other complexity categories had significantly higher mean medical visits and costs in both adjusted and unadjusted analyses. Fluctuating cognition was associated with the highest total costs, suggesting that this clinical feature in particular is associated with a considerable economic burden.
CONCLUSIONS AND IMPLICATIONS: Analyzing direct medical costs of DLB by disease complexity using claims data showed that a higher cost impact was associated with increasing number of clinical domains affected and with specific clinical domains, suggesting the need for both targeted and comprehensive interventions to improve the overall economic burden of DLB.