Impact of Coexisting Overactive Bladder in Medicare Patients With Dementia on Clinical and Economic Outcomes.

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY American Journal of Alzheimers Disease and Other Dementias Pub Date : 2019-11-01 Epub Date: 2019-04-09 DOI:10.1177/1533317519841164

Eleanor O Caplan, Ibrahim M Abbass, Brandon T Suehs, Daniel B Ng, Katherine Gooch, Derek van Amerongen

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Abstract

Background: Patients with dementia commonly suffer from symptoms of overactive bladder (OAB); however, limited research exists on the clinical impact of coexisting OAB among patients with dementia. As such, the objective of this study was to examine the impact of OAB on clinical outcomes, health-care resource use, and associated costs among patients with dementia.

Methods: We conducted a retrospective cohort analysis of patients with dementia using 3861 matched pairs of patients with and without OAB. Analyses were based on administrative claims data from January 1, 2007, to September 30, 2015, and compared clinical outcomes, health services use, and associated costs.

Results: Patients with dementia and OAB were more likely than those without OAB to have least one fall (incidence rate ratio [IRR]: 1.43, 95% confidence interval [CI], 1.22-1.68, P < .001), fracture (IRR: 1.23, 95% CI, 1.05-1.44, P = .008), combined fall/fracture (IRR: 1.25, 95% CI, 1.11-1.42, P < .001), or urinary tract infection (IRR: 2.75, 95% CI, 2.55-2.96, P < .001). Patients with dementia and OAB demonstrated greater utilization of all-cause encounter types compared to similar patients without coexisting OAB (P < .01). All-cause and dementia-related total health-care costs were approximately 23% (95% CI, 0.19-0.28, P < .001) and 13% (95% CI, 0.05-0.20, P = .001), respectively, greater than similar patients without coexisting OAB.

Conclusion: Coexisting OAB was associated with impacts on clinical outcomes, health-care resource utilization, and costs in patients with dementia.

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医疗保险痴呆症患者并发膀胱过度活动症对临床和经济结果的影响。

背景：痴呆症患者通常伴有膀胱过度活动症（OAB）症状；然而，有关痴呆症患者并发 OAB 的临床影响的研究却十分有限。因此，本研究旨在探讨膀胱过度活动症对痴呆症患者临床疗效、医疗资源使用和相关费用的影响：我们使用 3861 对患有和未患有 OAB 的配对患者对痴呆症患者进行了回顾性队列分析。分析基于 2007 年 1 月 1 日至 2015 年 9 月 30 日的行政报销数据，并比较了临床结果、医疗服务使用情况和相关费用：结果发现：痴呆症合并有 OAB 的患者比没有 OAB 的患者更容易发生至少一次跌倒（发生率比 [IRR]，1.43，95% 置信区间）：1.43，95% 置信区间 [CI]，1.22-1.68，P < .001）、骨折（IRR：1.23，95% CI，1.05-1.44，P = .008）、跌倒/骨折合并（IRR：1.25，95% CI，1.11-1.42，P < .001）或尿路感染（IRR：2.75，95% CI，2.55-2.96，P < .001）。与不合并 OAB 的同类患者相比，患有痴呆症和 OAB 的患者对全因就诊类型的使用率更高（P < .01）。与不合并 OAB 的同类患者相比，全因和痴呆相关的医疗保健总费用分别高出约 23% (95% CI, 0.19-0.28, P < .001) 和 13% (95% CI, 0.05-0.20, P = .001)：结论：合并 OAB 与痴呆症患者的临床结果、医疗资源利用率和费用的影响有关。

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

American Journal of Alzheimers Disease and Other Dementias GERIATRICS & GERONTOLOGY-CLINICAL NEUROLOGY

CiteScore

5.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： American Journal of Alzheimer''s Disease and other Dementias® (AJADD) is for professionals on the frontlines of Alzheimer''s care, dementia, and clinical depression--especially physicians, nurses, psychiatrists, administrators, and other healthcare specialists who manage patients with dementias and their families. This journal is a member of the Committee on Publication Ethics (COPE).