What happens after a single surgical intervention for hidradenitis suppurativa? A retrospective claims-based analysis

J Med Econ. 2016 Jul;19(7):710-7. doi: 10.3111/13696998.2016.1161636. Epub 2016 Mar 14.

Abstract

Objective Hidradenitis suppurativa (HS) is often treated by surgery. The risk of recurrence after surgery is common and the consequences are substantial, but neither has been quantified using a claims database. This study aimed to estimate the burden associated with non-curative surgery in HS patients. Methods A retrospective analysis was performed of health insurance claims data from Q1 1999 to Q2 2011 in a US claims database. The analysis included 2668 adults with ≥1 diagnosis of HS and ≥1 claim for skin surgery within 6 months after diagnosis. Healthcare resource utilization and medical costs were compared using multivariate regressions. Results Overall, 46% of HS patients had ≥1 indicator of non-curative surgery. The incidences of inpatient, emergency department, and outpatient visits were 88%, 40%, and 30% higher, respectively, for patients with non-curative surgery vs patients without indicator of non-curative surgery (all p < 0.001). Average medical costs were $11,858 and $6427 for patients with and without indicators of non-curative surgery, respectively. The difference of $4185 (p < 0.001) was mainly driven by inpatient costs (difference = $2685; p < 0.001). Limitations Indicators of non-curative HS surgery were defined based on an empirical algorithm. Conclusions Non-curative HS surgery occurred in almost half of all cases and represents a significant burden on patients and payers in terms of resource utilization and costs.

Keywords: Economic burden; Healthcare costs; Healthcare resource utilization; Hidradenitis suppurativa; Non-curative surgery.

MeSH terms

  • Adult
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Health Expenditures
  • Health Services / economics
  • Health Services / statistics & numerical data
  • Hidradenitis Suppurativa / economics*
  • Hidradenitis Suppurativa / surgery*
  • Humans
  • Insurance Claim Review
  • Male
  • Middle Aged
  • Models, Econometric
  • Recurrence
  • Regression Analysis
  • Retrospective Studies