https://scholars.lib.ntu.edu.tw/handle/123456789/578416
標題: | Protein-energy wasting significantly increases healthcare utilization and costs among patients with chronic kidney disease: a propensity-score matched cohort study | 作者: | CHIA-TER CHAO Tang C.-H. Cheng R.W.-Y. Wang M.Y.-H. KUAN-YU HUNG |
公開日期: | 2017 | 出版社: | Taylor and Francis Ltd | 卷: | 33 | 期: | 9 | 起(迄)頁: | 1705-1713 | 來源出版物: | Current Medical Research and Opinion | 摘要: | Background: Disease-related malnutrition is highly prevalent, and has prognostic implications for patients with chronic kidney disease (CKD); however, few studies have investigated the impact of malnutrition, or protein-energy wasting (PEW), on healthcare utilization and medical expenditure among CKD patients. Methods: Using claim data from the National Health Insurance in Taiwan, this study identified patients with CKD between 2009–2013 and categorized them into those with mild, moderate, or severe CKD. Cases with PEW after CKD was diagnosed were propensity-score matched with controls in a 1:4 ratio. Healthcare resource utilization metrics were compared, including outpatient and emergency department visits, frequency and duration of hospitalization, and the cumulative costs associated with different CKD severity. Results: From among 347,501 CKD patients, eligible cohorts of 66,872 with mild CKD (49.2%), 27,122 with moderate CKD (19.9%), and 42,013 with severe CKD (30.9%) were selected. Malnourished CKD patients had significantly higher rates of hospitalization (p <.001 for all severities) and re-admission (p =.015 for mild CKD, p =.002 for severe CKD) than non-malnourished controls. Cumulative medical costs for outpatient and emergency visits, and hospitalization, were significantly higher among all malnourished CKD patients than non-malnourished ones (p <.001); total medical costs were also higher among malnourished patients with mild (62.9%), moderate (59.6%), or severe (43.6%) CKD compared to non-malnourished patients (p <.001). Conclusions: In a nationally-representative cohort, CKD patients with PEW had significantly more healthcare resource utilization and higher aggregate medical costs than those without, across the spectrum of CKD: preventing PEW in CKD patients should receive high priority if we would like to reduce medical costs. ? 2017 Informa UK Limited, trading as Taylor & Francis Group. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85026507808&doi=10.1080%2f03007995.2017.1354823&partnerID=40&md5=955fc9df731df2defa2759461b7b3781 https://scholars.lib.ntu.edu.tw/handle/123456789/578416 |
ISSN: | 0300-7995 | DOI: | 10.1080/03007995.2017.1354823 | SDG/關鍵字: | aged; Article; chronic kidney failure; cohort analysis; controlled study; cost of illness; disease severity; emergency care; female; health care cost; health care utilization; hospital cost; hospital readmission; hospitalization; human; major clinical study; male; mild renal impairment; moderate renal impairment; outpatient care; propensity score; protein calorie malnutrition; severe renal impairment; chronic kidney failure; complication; cost; health care cost; middle aged; patient attitude; prevalence; prognosis; propensity score; protein calorie malnutrition; statistics and numerical data; Taiwan; very elderly; Aged; Aged, 80 and over; Cohort Studies; Costs and Cost Analysis; Female; Health Expenditures; Humans; Male; Middle Aged; Patient Acceptance of Health Care; Prevalence; Prognosis; Propensity Score; Protein-Energy Malnutrition; Renal Insufficiency, Chronic; Taiwan |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。