Hu X H, Markson L E, Lipton R B, Stewart W F, Berger M L
Outcomes Research and Management, US Human Health Division, Merck Co Inc, West Point, PA, USA.
Arch Intern Med. 1999 Apr 26;159(8):813-8. doi: 10.1001/archinte.159.8.813.
Migraine is a common disabling disease but its economic burden has not been adequately quantified.
To estimate the burden of migraine in the United States with respect to disability and economic costs.
The following data sources were used: published data, the Baltimore County Migraine Study, MEDSTAT's MarketScan medical claims data set, and statistics from the Census Bureau and the Bureau of Labor Statistics. Disability was expressed as bedridden days. Charges for migraine-related treatment were used as direct cost inputs. The human capital approach was used in the estimation of indirect costs.
Migraineurs required 3.8 bed rest days for men and 5.6 days for women each year, resulting in a total of 112 million bedridden days. Migraine costs American employers about $13 billion a year because of missed workdays and impaired work function; close to $8 billion was directly due to missed workdays. Patients of both sexes aged 30 to 49 years incurred higher indirect costs compared with younger or older employed patients. Annual direct medical costs for migraine care were about $1 billion and about $100 was spent per diagnosed patient. Physician office visits accounted for about 60% of all costs; in contrast, emergency department visits contributed less than 1% of the direct costs.
The economic burden of migraine predominantly falls on patients and their employers in the form of bedridden days and lost productivity. Various screening and treatment regimens should be evaluated to identify opportunities to reduce the disease burden.
偏头痛是一种常见的致残性疾病,但其经济负担尚未得到充分量化。
评估美国偏头痛在残疾和经济成本方面的负担。
使用了以下数据来源:已发表的数据、巴尔的摩县偏头痛研究、MEDSTAT的市场扫描医疗索赔数据集以及人口普查局和劳工统计局的统计数据。残疾以卧床天数表示。偏头痛相关治疗费用用作直接成本投入。采用人力资本法估算间接成本。
偏头痛患者男性每年需要3.8天卧床休息,女性为5.6天,总计1.12亿卧床天数。由于旷工和工作功能受损,偏头痛每年给美国雇主造成约130亿美元的损失;近80亿美元直接归因于旷工。与年轻或年长的在职患者相比,30至49岁的男女患者间接成本更高。偏头痛护理的年度直接医疗费用约为10亿美元,每位确诊患者花费约100美元。医生门诊就诊约占所有费用的60%;相比之下,急诊科就诊占直接成本的比例不到1%。
偏头痛的经济负担主要以卧床天数和生产力损失的形式落在患者及其雇主身上。应评估各种筛查和治疗方案,以确定减轻疾病负担的机会。