Snowden Cecelia B, Miller Ted R, Jensen Alan F, Lawrence Bruce A
Pacific Institute for Research and Evaluation, Calverton, MD 20705, USA.
Public Health Rep. 2003 Jan-Feb;118(1):10-7. doi: 10.1093/phr/118.1.10.
Determining the magnitude of the burden of diseases and health disorders on the U.S. population is a high priority for health policy makers. Conditions such as malignant neoplasms and injuries from craniofacial trauma contribute to adverse oral health. This study estimates the number of cases of diseases and disorders relevant to oral health that are treated annually in the medical care, as opposed to the dental care, system and associated costs. Policy makers can use this cost model to compare the impact of different conditions, to target areas for reducing costs, and to allocate appropriate health resources.
Data from four national and two state data systems were used to estimate the number of cases of selected dental, oral, and craniofacial diseases and conditions treated in the medical system annually and associated medical and wage/household work loss costs.
Per case, the most costly conditions were estimated to be malignant neoplasms at 83,080 US dollars annually (in 1999 dollars), diabetes-related oral conditions at 51,030 US dollars, endocarditis at 48,610 US dollars, and chlamydiae at 41,100 US dollars. Total estimated costs for oral conditions treated in the medical care system in 1996 were approximately 95.9 billion US dollars, including 21.4 billion US dollars in medical costs and 74.4 US dollars billion in wage/household work loss costs.
Conditions treated outside the dental care system are major contributors to oral health costs. They should be an important focus for the National Institute of Dental and Craniofacial Research.
确定疾病和健康失调对美国人口造成的负担程度,是卫生政策制定者的首要任务。恶性肿瘤和颅面部创伤所致损伤等情况会导致口腔健康问题。本研究估计了每年在医疗保健系统而非牙科保健系统中治疗的与口腔健康相关的疾病和失调病例数及相关成本。政策制定者可利用此成本模型比较不同情况的影响、确定降低成本的目标领域并分配适当的卫生资源。
使用来自四个国家级和两个州级数据系统的数据,估计每年在医疗系统中治疗的选定牙科、口腔和颅面部疾病及情况的病例数以及相关的医疗成本和工资/家庭工作损失成本。
按病例计算,估计成本最高的情况依次为:恶性肿瘤,每年83,080美元(按1999年美元计算);糖尿病相关口腔疾病,51,030美元;心内膜炎,48,610美元;衣原体感染,41,100美元。1996年在医疗保健系统中治疗的口腔疾病估计总成本约为959亿美元,其中医疗成本214亿美元,工资/家庭工作损失成本744亿美元。
在牙科保健系统之外治疗的情况是口腔健康成本的主要构成因素。它们应成为国立牙科和颅面部研究所的重要关注重点。