| 2 | Healthcare and economic impact of diarrhea in patientswith carcinoid syndrome显示文摘AIM To examine healthcare resource utilizationpatterns and costs accrued by carcinoid syndrome (CS)patients with and without diarrhea.METHODS: We conducted a retrospective cohort studyusing MarketScan data from 1/1/2002-12/31/2012.Newly diagnosed CS patients had 1 medical claim forCS (ICD-9-CM code 259.2) plus either ≥ 1 additionalclaim for CS or for carcinoid tumors (ICD-9-CM 209.x), and had no evidence of CS for 1 year prior to index CS diagnosis, in commercially-insured patients 〈 65years old. Patients were required to have continuousenrollment one year prior and after index date (firstclaim with CS diagnosis in the ID period). We identifiedpatients with evidence of non-infectious diarrhea (ICD-9-CM codes 564.5 and 787.91) within one year from theindex date. Overall and CS-related healthcare resourceutilization and costs were compared between patientswith and without non-infectious diarrhea during theone year period after the index date.RESULTS: There were 2822 newly diagnosed CSpatients; 534 (18.9%) had evidence of non-infectiousdiarrhea. Compared to patients without non-infectiousdiarrhea, non-infectious diarrhea patients morecommonly had at ≥ 1 CS-related hospitalization(13.7% vs 7.2%), ≥ 1 CS-related ED visit (11.0% vs4.4%), and CS-related office visits in one year (6.9 vs4.1; all p 〈 0.001). After adjusting for demographics,region, number of chronic conditions and the CharlsonComorbidity Index, the proportions of patients withany and with CS-related hospitalizations were 9.7%and 6.8% higher, respectively, among non-infectiousdiarrhea patients compared to those with without noninfectiousdiarrhea (p 〈 0.001). Unadjusted costs weresignificantly higher among non-infectious diarrheapatients vs those without non-infectious diarrhea. Thenon-infectious diarrhea group was also more costly,with adjusted mean annual costs of $81610, comparedto $51719 in the group without non-infectious diarrhea(p 〈 0.001).CONCLUSION: Diarrhea is burdensome and costlyin CS patients. Reduction of CS-related healthcareexpenditures may be achievable through preventivetreatment and appropriate management of diarrhea inCS. | Michael S Broder Eunice Chang Dorothy Romanus Dasha Cherepanov Maureen P Neary | 2016 | World Journal of Gastroenterology2016，22，6： | 1 |
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