title: Health care costs, utilization and patterns of care following Lyme disease.
abstract: BACKGROUND
  Lyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome - a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States.
  
  
  OBJECTIVE
  1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization.
  
  
  METHODS
  This study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure.
  
  
  RESULTS
  Lyme disease is associated with $2,968 higher total health care costs (95% CI: 2,807-3,128, p<.001) and 87% more outpatient visits (95% CI: 86%-89%, p<.001) over a 12-month period, and is associated with 4.77 times greater odds of having any PTLDS-related diagnosis, as compared to controls (95% CI: 4.67-4.87, p<.001). Among those with Lyme disease, having one or more PTLDS-related diagnosis is associated with $3,798 higher total health care costs (95% CI: 3,542-4,055, p<.001) and 66% more outpatient visits (95% CI: 64%-69%, p<.001) over a 12-month period, relative to those with no PTLDS-related diagnoses.
  
  
  CONCLUSIONS
  Lyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization.
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors: Emily R
authors: ER
authors: Adrion
authors: Johns Hopkins University School of Medicine, Division of Rheumatology, Johns Hopkins at Greenspring Station, 10755 Falls Road, Suite 200, Lutherville, Maryland, 21093, United States of America.
authors: John
authors: J
authors: Aucott
authors: Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America.
authors: Klaus W
authors: KW
authors: Lemke
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors: Jonathan P
authors: JP
authors: Weiner
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008193:Lyme Disease / Q000191:economics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
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