title: What happens after a single surgical intervention for hidradenitis suppurativa? A retrospective claims-based analysis.
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.
authors.affiliation: a Department of Dermatology , Roskilde Hospital , Roskilde , Denmark ;|e Health Sciences Faculty , University of Copenhagen , Copenhagen , Denmark.
authors.forename: Gregor B E
authors.initials: GB
authors.lastname: Jemec
authors.affiliation: b Analysis Group, Inc. , Boston , MA , USA ;
authors.forename: Annie
authors.initials: A
authors.lastname: Guérin
authors.affiliation: b Analysis Group, Inc. , Boston , MA , USA ;
authors.forename: Michael
authors.initials: M
authors.lastname: Kaminsky
authors.affiliation: c Fort HealthCare , Fort Atkinson , WI , USA ;
authors.forename: Martin
authors.initials: M
authors.lastname: Okun
authors.affiliation: d AbbVie Inc. , North Chicago , IL , USA ;
authors.forename: Murali
authors.initials: M
authors.lastname: Sundaram
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D017497:Hidradenitis Suppurativa / Q000191:economics* / Q000601:surgery*; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D012008:Recurrence; D012044:Regression Analysis; D012189:Retrospective Studies
keywords: Economic burden; Healthcare costs; Healthcare resource utilization; Hidradenitis suppurativa; Non-curative surgery