Brecht J G, Poldrugo F, Schädlich P K
InForMed Gesellschaft für interdisziplinäre Forschung und Beratung im Gesundheitswesen mbH, Hamburg, Germany.
Pharmacoeconomics. 1996 Nov;10(5):484-93. doi: 10.2165/00019053-199610050-00006.
The purpose of this study was to estimate the direct and indirect costs of alcoholism in the Federal Republic of Germany. Direct costs comprised treatment costs, while indirect costs consisted mainly of costs incurred as a result of work time lost, as well as costs related to premature retirement and premature mortality. The costs of alcoholism were estimated using the aggregated statistics of several social security organisations and official statistics. For the purposes of this study, alcoholism was defined as alcohol dependence syndrome [9th revision of the International Classification of Diseases code (ICD) 303], alcoholic chronic liver disease and cirrhosis (ICD 571.0 to 571.3), and alcoholic psychoses (ICD 291). The reference period consisted of the years 1985 to 1991. All statistics and all analyses were limited to the so-called old states of Germany, within the boundaries as they were before 3rd October 1990. The overall monetary burden (in 1990 Deutschemarks) of alcoholism in the western part of Germany in 1990 was estimated to be DM5975 million. Alcoholism is associated with considerably more indirect costs (DM4422 million) than direct costs (DM1553 million). The predominance of indirect costs is mainly the result of the very high premature mortality of patients with alcoholism. Thus, the cost of premature mortality makes up more than half of the indirect costs of alcoholism (DM2284 million), while about a quarter of the indirect costs (DM1150 million) are associated with inability to work. Early retirement accounts for a similar amount (DM988 million). The majority of direct costs is accounted for by treatment in acute hospitals (DM869 million). Costs incurred as a result of rehabilitation treatment (DM373 million) and ambulatory care (DM331 million) are also considerable.
本研究的目的是估算德意志联邦共和国酗酒的直接和间接成本。直接成本包括治疗费用，而间接成本主要包括因工作时间损失而产生的成本，以及与提前退休和过早死亡相关的成本。酗酒成本是利用几个社会保障组织的汇总统计数据和官方统计数据估算得出的。在本研究中，酗酒被定义为酒精依赖综合征[国际疾病分类代码（ICD）第9版303]、酒精性慢性肝病和肝硬化（ICD 571.0至571.3）以及酒精性精神病（ICD 291）。参考期为1985年至1991年。所有统计数据和分析均限于1990年10月3日之前边界范围内的德国所谓的旧州。1990年德国西部酗酒的总体货币负担（以1990年德国马克计）估计为5.975亿德国马克。酗酒的间接成本（4.422亿德国马克）比直接成本（1.553亿德国马克）多得多。间接成本占主导主要是因为酗酒患者过早死亡率非常高。因此，过早死亡成本占酗酒间接成本的一半以上（2.284亿德国马克），而约四分之一的间接成本（1.15亿德国马克）与无法工作有关。提前退休的成本数额与之相近（9.88亿德国马克）。大部分直接成本由急症医院的治疗费用构成（8.69亿德国马克）。康复治疗（3.73亿德国马克）和门诊护理（3.31亿德国马克）产生的费用也相当可观。
