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Medical Costs in Chronic Fatigue Syndrome (CFS): A Sample of Registry-Based Cases

Lo, Jeanie (2012)
Master's Thesis (91 pages)
Committee Chair / Thesis Adviser: Sullivan, Patrick S
Committee Members: Lin, Jin-Mann (CDC);
Research Fields: Health Sciences, Public Health
Partnering Agencies: CDC
Keywords: Chronic Fatigue Syndrome, CFS, economic impact, direct costs
Program: Rollins School of Public Health, Epidemiology (Epidemiology)
Permanent url: http://holden.library.emory.edu/ark:/25593/bpd6s

Abstract

Chronic fatigue syndrome (CFS) is a complex and deliberating chronic illness that affects at least 4 million people in the United States. Evaluating and assessing the economic impact of CFS will prove crucial in shaping future policies for clinical research, health institutions, and education in order to reduce the burden of disease. The objective of this study analysis is to estimate the medical costs among CFS patients identified from a registry pilot study in primary and tertiary healthcare settings as well as CFS patients identified from a self-referred support group between September 2008 and March 2010 in Georgia, USA. Participants completed a clinical evaluation to confirm CFS diagnosis and to identify other illnesses. Socio-demographic information including economic data and healthcare utilization was also collected. We estimated the effect of CFS on direct medical costs that included inpatient hospitalizations, provider encounter visits, over-the-counter medications, and other health care costs by stratifying on primary factor-referral status (n = 35) from Bibb County, Georgia and Macon City, Georgia. Linear regression models using Ordinary Least Squares were employed to adjust medical costs and earnings for confounders (age, sex, race, marital status, education, working status, healthcare coverage, and unmet need). Provider-referred CFS patients had mean annual direct medical costs of $2,462 after adjusting for potential confounders. After adjustment, sex was found to be statistically significant in the other health costs category (p=0.04). Additionally, unmet need was found to be statistically significant in both the total annual healthcare expenditures and provider encounter visits categories (p=0.02, p=0.04, respectively). Similarly, educational status was found to be statistically significant in both the total annual healthcare expenditures and provider encounter visits categories (p=0.03, p=0.03, respectively). These study results demonstrate that CFS may lead to considerable increases in medical costs. There is no known cure for CFS; therefore, treatment and management is long-term and the associated costs may be incurred over decades or even a lifetime. Lastly, this study may offer unique insight via the perspective of a clinical registry sample population.

Table of Contents

Table of Contents -- BACKGROUND ........................................................................................................................................... 1 -- METHODS ..................................................................................................................................................... 5 -- RESULTS ....................................................................................................................................................... 14 -- DISCUSSION ............................................................................................................................................... 18 -- CONCLUSION ............................................................................................................................................ 24 -- REFERENCES ............................................................................................................................................. 25 -- FIGURES ....................................................................................................................................................... 29 -- TABLES ......................................................................................................................................................... 30 -- ANNOTATED SAS CODE ...................................................................................................................... 37

Files

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