Health care resource use and costs in patients with food allergies: a United States insurance claims database analysis

Food allergies impose a large clinical and financial burden on patients and the health care system. However, little is known about the factors associated with health care resource use and costs. The aim of this study was to investigate health care resource use and costs in individuals with food allergies utilizing health care in the United States. We conducted a retrospective analysis of insurance claims data from the Merative MarketScan Research Databases (indexed from 1 January 2015 to 30 June 2022). All-cause and food allergy-related health care resource use, direct medical, and out-of-pocket costs for medical services were estimated for 12 months post-index using International Classification of Diseases [ICD] codes. Of 355,520 individuals with food allergies continuously enrolled in a health insurance plan for ≥12 months pre- and post-index, 17% had a food allergy-related emergency department visit and 0.9% were hospitalized. The top patient characteristic associated with all-cause and food allergy-related hospitalizations, all-cause costs, and food allergy-related outpatient visit costs was a Charlson Comorbidity Index score of ≥2. Food allergy-related direct medical and out-of-pocket costs were high among patients with a food allergy-related visit. Out-of-pocket cost per patient per year for outpatient visits, emergency department visits, and hospitalizations had an estimated mean of $1631 for patients with food allergy-related visits, which is ∼11% of the total costs for these services ($14,395 per patient per year). Study limitations are primarily related to the nature of claims databases, including generalizability and reliance on ICD codes. Nevertheless, MarketScan databases provide robust patient-level insights into health care resource use and costs from a large, commercially insured patient population. The health care resource use of patients with food allergies imposes a burden on both the health care system and on patients and their families, especially if patients had comorbidities. Some people with food allergies might need extra visits to the doctor or hospital to manage allergic reactions to food, and these visits add to the cost of medical services for both families and for health care providers. Using records of health insurance claims, we looked into the factors affecting medical visits and costs in people with food allergies in the United States. For people with food allergies, having additional medical conditions (measured using the Charleson Comorbidity Index) were linked with extra medical visits and costs. Out-of-pocket costs were high for people who visited a doctor or hospital for their food allergies (costing each person more than $1,600 per year). The total medical cost of food allergy-related care was $14,395 per person per year, paid for by families and health care providers. Our findings might help to better manage and treat people with food allergies and reduce medical costs.

食物过敏给患者及医疗体系带来了巨大的临床和财务负担。然而，关于与健康医疗资源利用和成本相关的因素所知甚少。本研究旨在调查使用美国医疗体系的食物过敏患者健康医疗资源利用和成本。我们对Merative MarketScan研究数据库（索引时间从2015年1月1日至2022年6月30日）中的保险索赔数据进行回顾性分析。使用国际疾病分类[ICD]代码，对索引后12个月内的所有原因和食物过敏相关医疗资源利用、直接医疗费用和自付费用进行估算。在355,520名在索引前后连续参加健康保险计划≥12个月的食物过敏患者中，17%有食物过敏相关的急诊室就诊记录，0.9%的患者被收入院。与所有原因和食物过敏相关住院、所有原因成本以及食物过敏相关门诊就诊成本相关的最显著患者特征是Charlson合并症指数评分≥2。食物过敏相关直接医疗费用和自付费用在食物过敏相关就诊的患者中较高。门诊就诊、急诊室就诊和住院的自付费用每人每年平均约为1631美元，这约占这些服务总成本（每人每年14,395美元）的11%。研究的局限性主要与索赔数据库的性质相关，包括普适性和对ICD代码的依赖。尽管如此，MarketScan数据库为大型商业保险患者群体提供了对患者健康医疗资源利用和成本的稳健患者层级洞察。食物过敏患者的健康医疗资源利用对医疗体系以及患者及其家庭构成了负担，尤其是当患者合并其他疾病时。一些食物过敏患者可能需要额外就诊于医生或医院以管理食物过敏反应，这些就诊增加了家庭和医疗提供者的医疗服务成本。通过使用健康保险索赔记录，我们研究了影响美国食物过敏患者医疗就诊和成本的因素。对于食物过敏患者而言，具有额外的医疗条件（使用Charlson合并症指数进行衡量）与额外的医疗就诊和成本相关。对于因食物过敏就诊于医生或医院的患者，自付费用较高（每人每年超过1600美元）。食物过敏相关医疗服务的总成本为每人每年14,395美元，由家庭和医疗提供者承担。我们的研究结果可能有助于更好地管理和治疗食物过敏患者，并降低医疗成本。