Characteristics of chronic intestinal failure in the USA based on analysis of claims data.

Autor: Mundi MS; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA., Mercer DF; Department of Surgery, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, Nebraska, USA., Iyer K; Recanati Miller Transplant Institute, Department of Surgery, Mount Sinai Hospital, New York, New York, USA., Pfeffer D; Eversana, New York, New York, USA., Zimmermann LB; Zealand Pharma A/S, Søborg, Denmark., Berner-Hansen M; Zealand Pharma A/S, Søborg, Denmark.; Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark., Bishop J; The Oley Foundation, Albany Medical Center, Delmar, New York, USA., Seidner DL; Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio, USA.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2022 Sep; Vol. 46 (7), pp. 1614-1622. Date of Electronic Publication: 2022 Jul 24.
DOI: 10.1002/jpen.2426
Abstrakt: Background: This study investigated the prevalence, characteristics, and management of patients with chronic intestinal failure (CIF) in the United States in 2012-2020, based on parenteral support (PS) prescription claims and healthcare utilization.
Methods: Patients with CIF were identified from the Integrated DataVerse® claims database if they had at least two PS prescriptions within 6 months and a relevant diagnosis. Analysis included prevalence and characteristics of patients with CIF, their travel distance to receive PS prescriptions, and the distribution of PS providers and their prescribing history.
Results: Up to 24,048 patients with CIF were identified, equivalent to 75 patients per million. CIF affected people of all ages, being more prevalent in women than in men. Many providers signed PS orders for small patient groups over short time periods, whereas few providers signed PS orders for large patient groups long term, indicating a lack of centralization. The distribution of PS providers suggested a disparity in healthcare coverage in rural vs urban areas, leading to patients traveling considerable distances to receive PS prescriptions. This may be exacerbated by a decline of providers with expertise in CIF and nutrition.
Conclusions: Healthcare disparities for patients with CIF have likely been obscured by the lack of CIF-specific diagnostic and procedure codes, obliging providers to code for their patients under other codes. Effective policy changes, including centralized care, revision of reimbursement models, and expansion of nutrition-focused education in addition to the newly introduced International Classification of Diseases codes, are needed to provide the best care for patients.
(© 2022 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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