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 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.
['Lobatto|Daniel J|DJ|0000-0002-2523-8707', 'van den Hout|Wilbert B|WB|', 'Zamanipoor Najafabadi|Amir H|AH|', 'Steffens|Anath N V|ANV|', 'Andela|Cornelie D|CD|', 'Pereira|Alberto M|AM|', 'Peul|Wilco C|WC|', 'van Furth|Wouter R|WR|', 'Biermasz|Nienke R|NR|', 'Vliet Vlieland|Thea P M|TPM|']
D000236:Adenoma D000368:Aged D003430:Cross-Sectional Studies D005260:Female D005102:Health Expenditures D006304:Health Status D006801:Humans D008297:Male D008875:Middle Aged D010342:Patient Acceptance of Health Care D010911:Pituitary Neoplasms D011795:Surveys and Questionnaires
Healthcare utilization Costs Pituitary adenoma NFPA Multidisciplinary Value based healthcare