Healthcare utilization and costs among patients with non-functioning pituitary adenomas

Purpose Non-functioning pituitary adenomas (NFPA) have a substantial impact on patients’ health status, yet research on the extent of healthcare utilization and costs among these patients is scarce. The objective was to determine healthcare usage, associated costs, and their determinants among patie...

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Bibliographic Details
Published in:Endocrine 2019-05, Vol.64 (2), p.330-340
Main Authors: Lobatto, Daniel J., van den Hout, Wilbert B., Zamanipoor Najafabadi, Amir H., Steffens, Anath N. V., Andela, Cornelie D., Pereira, Alberto M., Peul, Wilco C., van Furth, Wouter R., Biermasz, Nienke R., Vliet Vlieland, Thea P. M.
Format: Article
Language:English
Subjects:
Adenoma - economics
Aged
Cross-Sectional Studies
Diabetes
Emergency medical care
Endocrinology
Female
Health Expenditures
Health Status
Humanities and Social Sciences
Humans
Internal Medicine
Male
Medical records
Medicine
Medicine & Public Health
Middle Aged
multidisciplinary
Original
Original Article
Patient Acceptance of Health Care
Patients
Pituitary
Pituitary Neoplasms - economics
Questionnaires
Science
Surveys and Questionnaires
Tumors
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Summary:Purpose Non-functioning pituitary adenomas (NFPA) have a substantial impact on patients’ health status, yet research on the extent of healthcare utilization and costs among these patients is scarce. The objective was to determine healthcare usage, associated costs, and their determinants among patients treated for an NFPA. Methods In a cross-sectional study, 167 patients treated for an NFPA completed four validated questionnaires. Annual healthcare utilization and associated costs were assessed through the medical consumption questionnaire (MTA iMCQ). In addition, the Leiden Bother and Needs Questionnaire for pituitary patients (LBNQ-Pituitary), Short Form-36 (SF-36), and EuroQol (EQ-5D) were administered. Furthermore, age, sex, endocrine status, treatment, and duration of follow-up were extracted from the medical records. Associations were analyzed using logistic/linear regression. Results Annual healthcare utilization included: consultation of an endocrinologist (95% of patients), neurosurgeon (14%), and/or ophthalmologist (58%). Fourteen percent of patients had ≥1 hospitalization(s) and 11% ≥1 emergency room visit(s). Mean overall annual healthcare costs were € 3040 (SD 6498), highest expenditures included medication (31%), inpatient care (28%), and specialist care (17%). Factors associated with higher healthcare utilization and costs were greater self-perceived disease bother and need for support, worse mental and physical health status, younger age, and living alone. Conclusion Healthcare usage and costs among patients treated for an NFPA are substantial and were associated with self-perceived health status, disease bother, and healthcare needs rather than endocrine status, treatment, or duration of follow-up. These findings suggest that targeted interventions addressing disease bother and unmet needs in the chronic phase are needed.
ISSN:1355-008X
1559-0100
DOI:10.1007/s12020-019-01847-7