성인 아토피 피부염 환자의 우울증 동반에 따른 점증적 비용 부담: 후향적 단면연구
Incremental Economic Burden of Comorbid Major Depressive Disorder in Adult Atopic Dermatitis Patients: A Retrospective Cross-Sectional Study
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives: This study aims to assess the incremental economic burden of major depressive disorder (MDD) in adult atopic dermatitis (AD) patients. Methods: A retrospective, cross-sectional study was performed using 2018 Health Insurance Review and Assessment Service-National Patient Sample data. The incremental economic burden was assessed between adult AD patients with MDD (AD with MDD) and adult AD patients without MDD (AD without MDD). We defined adult AD patients as those aged≥20 years who had at least two claim records with diagnosis of AD. AD with MDD were defined as AD patients having at least two claim records with diagnosis of MDD. AD without MDD were defined as those who had no claim record with diagnosis of MDD. AD without MDD matched by propensity score according to age, gender, and type of national security program were defined using a 1:2 greedy matching method. Medical costs were estimated by National Health Insurance (NHI)-covered medical costs. The ratio of medical costs between AD with MDD and matched-AD without MDD was adjusted for Charlson Comorbidity Index in the generalized linear model. Results: AD with MDD (n=371) had statistically higher hospital admission risk and outpatient visits (1.86-fold, p<0.0001) and tertiary-care hospital visits (2.86-fold, p<0.0001) compared to matched-AD without MDD (n=742). The annual average NHI-covered medical costs per patient were estimated to be 4,903,870 Korean Won (KRW) for AD with MDD and 2,804,183 KRW for matched-AD without MDD, resulting in cost ratio of 1.75-fold (p<0.0001). In the multivariate regression model, the medical cost per patient was 1.45-fold (95% Cl: 1.30−1.62) higher for AD with MDD than matched-AD without MDD. Conclusion: This study demonstrates a significant incremental economic burden of comorbid MDD in adult AD patients. Thus, greater emphasis on the prevention and treatment of MDD in adult AD patients is warranted.
Abstract
Objectives: This study aims to assess the incremental economic burden of major depressive disorder (MDD) in adult atopic dermatitis (AD) patients. Methods: A retrospective, cross-sectional study was performed using 2018 Health Insurance Review and Assessment Service-National Patient Sample data. The incremental economic burden was assessed between adult AD patients with MDD (AD with MDD) and adult AD patients without MDD (AD without MDD). We defined adult AD patients as those aged≥20 years who had at least two claim records with diagnosis of AD. AD with MDD were defined as AD patients having at least two claim records with diagnosis of MDD. AD without MDD were defined as those who had no claim record with diagnosis of MDD. AD without MDD matched by propensity score according to age, gender, and type of national security program were defined using a 1:2 greedy matching method. Medical costs were estimated by National Health Insurance (NHI)-covered medical costs. The ratio of medical costs between AD with MDD and matched-AD without MDD was adjusted for Charlson Comorbidity Index in the generalized linear model. Results: AD with MDD (n=371) had statistically higher hospital admission risk and outpatient visits (1.86-fold, p<0.0001) and tertiary-care hospital visits (2.86-fold, p<0.0001) compared to matched-AD without MDD (n=742). The annual average NHI-covered medical costs per patient were estimated to be 4,903,870 Korean Won (KRW) for AD with MDD and 2,804,183 KRW for matched-AD without MDD, resulting in cost ratio of 1.75-fold (p<0.0001). In the multivariate regression model, the medical cost per patient was 1.45-fold (95% Cl: 1.30−1.62) higher for AD with MDD than matched-AD without MDD. Conclusion: This study demonstrates a significant incremental economic burden of comorbid MDD in adult AD patients. Thus, greater emphasis on the prevention and treatment of MDD in adult AD patients is warranted.
참고문헌 (17)
- Drucker AM, "Atopic dermatitis : burden of illness, quality of life, and associated complications", Allergy Asthma Proc, 38, pp.3~8 (2017)
- Weidinger S, "Atopic dermatitis", Lancet, 387, pp.1109~1122 (2016)
- 김규한, "아토피피부염의 우리나라 현황 및 특징", 대한의사협회지, 57(3), pp.208~211 (2014), 대한의사협회[DOI]
- Nicholas MN, "Atopic dermatitis, depression, and suicidality", J Cutan Med Surg, 21, pp.237~242 (2017)
- Lee SH, "Psychological health status and health-related quality of life in adults with atopic dermatitis : a nationwide cross-sectional study in South Korea", Acta Derm Venereol, 98, pp.89~97 (2018)
- Lee S, "Association of atopic dermatitis with depressive symptoms and suicidal behaviors among adolescents in Korea : the 2013 Korean Youth Risk Behavior Survey", BMC Psychiatry, 17, pp.3~ (2017)
- Hayon Michelle Choi, "Estimating causal associations of atopic dermatitis with depression using the propensity score method: an analysis of Korea Community Health Service data, 2010-2013", Epidemiology and Health, 40, pp.1~8 (2018), 한국역학회[DOI]
- Cheng BT, "Depression and psychological distress in US adults with atopic dermatitis", Ann Allergy Asthma Immunol, 123, pp.179~185 (2019)
- "Homepage on the Internet" (2018)[URL]
- Quan H, "Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data", Med Care, 43, pp.1130~1139 (2005)
- Jones AM, "The Oxford handbook of economic forecasting", pp.625~654 (2011), Oxford University Press
- Manning WG, "Estimating log models : to transform or not to transform", J Health Econ, 20, pp.461~494 (2001)
- Dodd S, "A comparison of multivariable regression models to analyse cost data", J Eval Clin Pract, 12, pp.76~86 (2006)
- Eichenfield LF, "Guidelines of care for the management of atopic dermatitis : section 1. Diagnosis and assessment of atopic dermatitis", J Am Acad Dermatol, 70, pp.338~351 (2014)
- Singh P, "Underscreening of depression in U. S. outpatients with atopic dermatitis and psoriasis", Br J Dermatol, 182, pp.1057~1059 (2020)
- Citrome L, "Prevalence, treatment patterns, and stay characteristics associated with hospitalizations for major depressive disorder", J Affect Disord, 249, pp.378~384 (2019)
- Lee BW, "Treatment of childhood atopic dermatitis and economic burden of illness in Asia Pacific countries", Ann Nutr Metab, 66(Suppl 1), pp.18~24 (2015)