Healthcare Costs and Resource Use Associated With Cervical Intraepithelial Neoplasia and Cervical Conization: A Retrospective Study of German Statutory Health Insurance Claims Data
**Background:** Cervical intraepithelial neoplasia (CIN) can be a consequence of human papillomavirus (HPV) infection. High-grade CIN (CIN2/CIN3) may develop from persistent HPV infection and progress to cervical cancer if left untreated. Management of CIN includes conservative surveillance or ablat...
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| Format: | Article |
| Language: | English |
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Columbia Data Analytics, LLC
2022-05-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/001c.35329 |
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| author | Anna-Janina Stephan Miriam Reuschenbach Kunal Saxena Vimalanand S. Prabhu Christian Jacob Kim M. Schneider Wolfgang Greiner Regine Wölle Monika Hampl |
| author_facet | Anna-Janina Stephan Miriam Reuschenbach Kunal Saxena Vimalanand S. Prabhu Christian Jacob Kim M. Schneider Wolfgang Greiner Regine Wölle Monika Hampl |
| author_sort | Anna-Janina Stephan |
| collection | DOAJ |
| description | **Background:** Cervical intraepithelial neoplasia (CIN) can be a consequence of human papillomavirus (HPV) infection. High-grade CIN (CIN2/CIN3) may develop from persistent HPV infection and progress to cervical cancer if left untreated. Management of CIN includes conservative surveillance or ablation and excision by conization. Internationally, CIN and its treatment generate a considerable economic burden, but no current data regarding costs and resource use from the perspective of the German statutory health insurance exist.
**Objectives:** The aim of this study was to explore the health economic burden in women with CIN diagnoses who either underwent cervical conization or were managed conservatively.
**Methods:** We conducted a retrospective claims data analysis using the InGef Research Database from 2013 to 2018. Healthcare costs and resource utilization in a 24-month observation period (1:1:1 matching) were compared in 18- to 45-year-old women with CIN (1-3) who underwent a conization procedure (study cohort 1) and in women with CIN (1-3) who did not undergo conization (study cohort 2) to women with neither CIN nor conization (control group).
**Results:** For each group, 2749 women were identified. Mean total healthcare costs after 24 months were higher in study cohort 1 (€4446, _P_<.01) and study cohort 2 (€3754, _P_=.09) compared with the control group (€3426). Comparing study cohort 1 and 2 to controls, mean differences were highest in age groups 41-45 years (cohort 1: €5115 vs €3354, _P_<.01; cohort 2: €4152 vs €3354, _P_=.14). Significantly more women were hospitalized at least once in study cohort 1 (57.46%, _P_<.01) and study cohort 2 (38.74%, _P_<.01) compared with the control group (31.14%). Frequency of outpatient physician visits was significantly higher in both study cohorts (43.23 visits, P<.01 and 38.60 visits, _P_<.01) compared with the control group (32.07 visits).
**Conclusion:** Our results revealed 30% and 10% increased total healthcare costs in women with CIN undergoing invasive treatment (study cohort 1) and conservative management (study cohort 2), respectively, compared with a control group of women with no CIN in a 2-year follow-up period. |
| format | Article |
| id | doaj-art-7a55e16d11d241ff8d1c7082976fc58c |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2022-05-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-7a55e16d11d241ff8d1c7082976fc58c2025-02-10T16:13:13ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362022-05-0191Healthcare Costs and Resource Use Associated With Cervical Intraepithelial Neoplasia and Cervical Conization: A Retrospective Study of German Statutory Health Insurance Claims DataAnna-Janina StephanMiriam ReuschenbachKunal SaxenaVimalanand S. PrabhuChristian JacobKim M. SchneiderWolfgang GreinerRegine WölleMonika Hampl**Background:** Cervical intraepithelial neoplasia (CIN) can be a consequence of human papillomavirus (HPV) infection. High-grade CIN (CIN2/CIN3) may develop from persistent HPV infection and progress to cervical cancer if left untreated. Management of CIN includes conservative surveillance or ablation and excision by conization. Internationally, CIN and its treatment generate a considerable economic burden, but no current data regarding costs and resource use from the perspective of the German statutory health insurance exist. **Objectives:** The aim of this study was to explore the health economic burden in women with CIN diagnoses who either underwent cervical conization or were managed conservatively. **Methods:** We conducted a retrospective claims data analysis using the InGef Research Database from 2013 to 2018. Healthcare costs and resource utilization in a 24-month observation period (1:1:1 matching) were compared in 18- to 45-year-old women with CIN (1-3) who underwent a conization procedure (study cohort 1) and in women with CIN (1-3) who did not undergo conization (study cohort 2) to women with neither CIN nor conization (control group). **Results:** For each group, 2749 women were identified. Mean total healthcare costs after 24 months were higher in study cohort 1 (€4446, _P_<.01) and study cohort 2 (€3754, _P_=.09) compared with the control group (€3426). Comparing study cohort 1 and 2 to controls, mean differences were highest in age groups 41-45 years (cohort 1: €5115 vs €3354, _P_<.01; cohort 2: €4152 vs €3354, _P_=.14). Significantly more women were hospitalized at least once in study cohort 1 (57.46%, _P_<.01) and study cohort 2 (38.74%, _P_<.01) compared with the control group (31.14%). Frequency of outpatient physician visits was significantly higher in both study cohorts (43.23 visits, P<.01 and 38.60 visits, _P_<.01) compared with the control group (32.07 visits). **Conclusion:** Our results revealed 30% and 10% increased total healthcare costs in women with CIN undergoing invasive treatment (study cohort 1) and conservative management (study cohort 2), respectively, compared with a control group of women with no CIN in a 2-year follow-up period.https://doi.org/10.36469/001c.35329 |
| spellingShingle | Anna-Janina Stephan Miriam Reuschenbach Kunal Saxena Vimalanand S. Prabhu Christian Jacob Kim M. Schneider Wolfgang Greiner Regine Wölle Monika Hampl Healthcare Costs and Resource Use Associated With Cervical Intraepithelial Neoplasia and Cervical Conization: A Retrospective Study of German Statutory Health Insurance Claims Data Journal of Health Economics and Outcomes Research |
| title | Healthcare Costs and Resource Use Associated With Cervical Intraepithelial Neoplasia and Cervical Conization: A Retrospective Study of German Statutory Health Insurance Claims Data |
| title_full | Healthcare Costs and Resource Use Associated With Cervical Intraepithelial Neoplasia and Cervical Conization: A Retrospective Study of German Statutory Health Insurance Claims Data |
| title_fullStr | Healthcare Costs and Resource Use Associated With Cervical Intraepithelial Neoplasia and Cervical Conization: A Retrospective Study of German Statutory Health Insurance Claims Data |
| title_full_unstemmed | Healthcare Costs and Resource Use Associated With Cervical Intraepithelial Neoplasia and Cervical Conization: A Retrospective Study of German Statutory Health Insurance Claims Data |
| title_short | Healthcare Costs and Resource Use Associated With Cervical Intraepithelial Neoplasia and Cervical Conization: A Retrospective Study of German Statutory Health Insurance Claims Data |
| title_sort | healthcare costs and resource use associated with cervical intraepithelial neoplasia and cervical conization a retrospective study of german statutory health insurance claims data |
| url | https://doi.org/10.36469/001c.35329 |
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