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Healthcare Utilization in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome(ME/CFS): Analysis of US Ambulatory Healthcare Data, 2000-2009

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dc.contributor.authorJaeyong Bae
dc.contributor.authorJin-Mann S. Lin
dc.date.accessioned2020-02-21T06:59:08Z
dc.date.available2020-02-21T06:59:08Z
dc.date.issued2019-05-14
dc.identifier.issn2296-2360
dc.identifier.urihttps://repository.kihasa.re.kr/handle/201002/34145
dc.description.abstractBackground: ME/CFS is a complex and disabling illness with substantial economic burden and functional impairment comparable to heart disease and multiple sclerosis. Many patients with ME/CFS do not receive appropriate healthcare, partially due to lack of diagnostic tests, and knowledge/attitudes/beliefs about ME/CFS. This study was to assess the utility of US ambulatory healthcare data in profiling demographics, co-morbidities, and healthcare in ME/CFS. Methods: Data came from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) in the U.S. Weighted analysis was performed. We examined 9.06 billion adult visits from 2000 to 2009 NAMCS/NHAMCS data. ME/CFS-related visits were identified by ICD-9-CM code, 780.71, up to tertiary diagnosis. Results: We estimated 2.9 million (95% CI: 1.8–3.9 million) ME/CFS-related visits during 2000–2009, with no statistical evidence (p-trend = 0.31) for a decline or increase in ME/CFS-related visits. Internists, general and family practitioners combined provided 52.12% of these visits. Patients with ME/CFS-related visits were mostly in their 40 and 50s (47.76%), female (66.07%), white (86.95%), metropolitan/urban residents (92.05%), and insured (87.26%). About 71% of ME/CFS patients had co-morbidities, including depression (35.79%), hypertension (31.14%), diabetes (20.30%), and arthritis (14.11%). As one quality indicator, physicians spent more time on ME/CFS-related visits than non-ME/CFS visits (23.62 vs. 19.38min, p = 0.065). As additional quality indicators, the top three preventive counseling services provided to patients with ME/CFS-related visits were diet/nutrition (8.33%), exercise (8.21%), and smoking cessation (7.24%). Compared to non-ME/CFS visits, fewer ME/CFS-related visits included counseling for stress management (0.75 vs. 3.14%, p = 0.010), weight reduction (0.88 vs. 4.02%, p = 0.002), injury prevention (0.04 vs. 1.64%, p < 0.001), and family planning/contraception (0.17 vs. 1.45%, p = 0.037). Conclusions: Visits coded with ME/CFS did not increase from 2000 to 2009. Almost three quarters of ME/CFS-related visits were made by ME/CFS patients with other co-morbid conditions, further adding to complexity in ME/CFS healthcare. While physiciansspentmoretimewithME/CFSpatients,alowerproportionofME/CFSpatients received preventive counseling for weight reduction, stress management, and injury prevention than other patients despite the complexity of ME/CFS. NAMCS/NHAMCS data are useful in evaluating co-morbidities, healthcare utilization, and quality indicators for healthcare in ME/CFS.
dc.format.extent9
dc.languageeng
dc.publisherFrontiers Media SA
dc.titleHealthcare Utilization in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome(ME/CFS): Analysis of US Ambulatory Healthcare Data, 2000-2009
dc.typeArticle
dc.type.localArticle(Academic)
dc.subject.keywordmyalgic encephalomyelitis
dc.subject.keywordchronic fatigue syndrome
dc.subject.keywordNational Ambulatory Medical Care Survey (NAMCS)
dc.subject.keywordco-morbidities
dc.subject.keywordhealthcare utilization
dc.subject.keywordquality indicators of healthcare
dc.contributor.affiliatedAuthorJaeyong Bae
dc.identifier.doi10.1016/j.ypmed.2016.03.017
dc.identifier.urlhttps://doi.org/10.1016/j.ypmed.2016.03.017
dc.identifier.localIdKIHASA-3437
dc.citation.titleFrontiers in Pediatrics
dc.citation.volume7
dc.citation.number185
dc.citation.date2019
dc.citation.startPage1
dc.citation.endPage9
dc.identifier.bibliographicCitationFrontiers in Pediatrics, vol. 7, no. 185, pp. 1 - 9
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