Methods: Using Medicare medical and pharmacy claims between January 1, 2007 and May 31, 2014, NTM lung infection patients (defined by ≥2 separate medical claims for NTM lung infection [ICD-9-CM 031.0]) (n=738) and matched controls (n=5166) were identified; first diagnosis served as the index date. Both groups had ≥18 months of continuous enrollment pre-index. Demographic and treatment characteristics and pre-index utilization patterns were examined. Differences in pre-index comorbidities were generated as odds ratios (OR) by ICD-9-CM chapters.
Results: Comorbidities analyses showed NTM lung infection patients have significantly higher OR vs controls for 3 ICD-9-CM chapters 3 months prediagnosis: Respiratory System (RR=35.3); Symptoms, Signs, and Ill-defined Conditions (RR=16.3); Infectious and Parasitic Diseases (RR=11.4). Scores are higher as early as 3rd quarter prediagnosis. Pre-index healthcare resource utilization was significantly higher across all categories for NTM lung infection patients vs matched controls (all P<.0001).
Conclusion: Comorbidity results indicate physicians are applying broad diagnoses in the respiratory, infectious disease and ill-defined condition areas prior to NTM lung infection diagnosis. These patterns are evident ≤9 months prior to diagnosis, suggesting a delay in identifying NTM lung infection and may account for why these patients are utilizing more resources than matched controls during that period. Findings suggest healthcare providers would benefit from better diagnostic tools related to this condition.
R. Dufour, None
K. McDermott, None
A. Tarr, None