Kiivet R A, Kaur I, Lang A, Aaviksoo A, Nirk L
University of Tartu, Department of Public Health, Ravila 19, EE 50411, Tartu, Estonia.
Eur J Public Health. 2001 Mar;11(1):89-92. doi: 10.1093/eurpub/11.1.89.
The aim of this study was to describe the distribution of the direct costs of asthma in Estonia by the type of treatment received and to differentiate the costs by age of patients.
Data were obtained from the databases of national health insurance offices. Persons who had been in a hospital or visited a doctor because of asthma and who also purchased anti-asthmatic drugs during 1997 were identified. The bills of all direct costs of health insurance for each asthma patient could thus be summarised. The data on all purchases of drugs were used to follow the patterns of drug treatment of asthma.
The mean annual treatment costs of one asthma patient were 118 EUR. The costs of hospital care accounted for 27%, costs of ambulatory care for 20% and costs of pharmacotherapy for 53% of all treatment costs. Beta-agonists and corticosteroids for inhalation accounted for more than 80% of prescriptions and 90% of pharmacotherapy costs in patients under 45 years. The users of oral corticosteroids had twice as high per capita annual asthma treatment costs as compared to non-users.
The frequency of out-patient visits, hospital admissions, number of prescriptions, total costs and costs of pharmaceuticals increased in parallel with age. The total estimated direct costs of asthma diagnosis and treatment during 1997, as extrapolated from the study population, were 2.1 million EUR, and accounted for 1.4% of direct health care costs in Estonia.
本研究旨在按所接受的治疗类型描述爱沙尼亚哮喘直接成本的分布情况，并按患者年龄区分成本。
数据取自国家健康保险办公室的数据库。确定了1997年因哮喘住院或看医生且购买了抗哮喘药物的人员。这样就可以汇总每个哮喘患者医疗保险所有直接成本的账单。利用所有药品购买数据来追踪哮喘药物治疗模式。
一名哮喘患者的年均治疗成本为118欧元。住院护理成本占所有治疗成本的27%，门诊护理成本占20%，药物治疗成本占53%。45岁以下患者中，吸入用β受体激动剂和皮质类固醇占处方的80%以上，占药物治疗成本的90%。口服皮质类固醇使用者的人均年哮喘治疗成本是非使用者的两倍。
门诊就诊频率、住院次数、处方数量、总成本和药品成本均随年龄增长而增加。根据研究人群推断，1997年哮喘诊断和治疗的估计直接总成本为210万欧元，占爱沙尼亚直接医疗保健成本的1.4%。
