Gutjahr E, Gmel G
Schweizerische Fachstelle für Alkohol- und andere Drogenprobleme, Lausanne/Schweiz, Switzerland.
Psychiatr Prax. 2001 Jul;28 Suppl 1:S45-54. doi: 10.1055/s-2001-15387.
The present contribution aims at illustrating the methodological problems that may arise from investigating the indirect social costs of alcohol consumption.
In order to estimate the alcohol-related productivity losses through excessive morbidity, regression analysis was performed, using data from the 2(nd) Swiss Health Survey (1997). For the purpose of sensitivity analysis two approaches were used (a) Rice and b) Harwood), and all models were calculated with and without smearing-adjustment as well as with and without adjustment for confounding variables.
The present study shows that small changes in method may result in major variations in the estimated total costs. In monetary terms, the indirect costs for alcohol consumption in Switzerland through excess-morbidity were estimated at between 0.119 billion Francs (model Harwood, smearing-adjusted) and 2.175 billions Francs (model Rice, adjusted for confounding variables).
Since many methodological problems in estimating the indirect costs of alcohol consumption have not been adequately resolved yet, results of those studies have to be interpreted with caution.
本论文旨在阐明调查酒精消费的间接社会成本时可能出现的方法学问题。
为了通过过高发病率估算与酒精相关的生产力损失，利用第二次瑞士健康调查（1997年）的数据进行了回归分析。为进行敏感性分析，采用了两种方法（a）赖斯法和（b）哈伍德法，所有模型均在进行和不进行涂抹调整以及进行和不进行混杂变量调整的情况下进行计算。
本研究表明，方法上的微小变化可能导致估计总成本出现重大差异。从货币角度来看，瑞士因过高发病率导致的酒精消费间接成本估计在1.19亿瑞士法郎（哈伍德模型，经涂抹调整）至21.75亿瑞士法郎（赖斯模型，经混杂变量调整）之间。
由于估算酒精消费间接成本时的许多方法学问题尚未得到充分解决，这些研究结果必须谨慎解读。
