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加拿大慢性阻塞性肺疾病的负担:直面慢性阻塞性肺疾病调查结果

The burden of COPD in Canada: results from the Confronting COPD survey.

作者信息

Chapman K R, Bourbeau J, Rance L

机构信息

University of Toronto, Ontario, Canada.

出版信息

Respir Med. 2003 Mar;97 Suppl C:S23-31. doi: 10.1016/s0954-6111(03)80022-7.

Abstract

Chronic obstructive pulmonary disease (COPD) is a condition characterized by progressive airflow limitation, with symptoms of dyspnoea, cough, and sputum production. Aside from information on prevalence, mortality and hospital resource utilization arising from COPD in Canada, there is a lack of data on the impact of the disease on primary care healthcare resource utilization and the economic burden of the disease (i.e. direct and indirect costs). Canada is not unusual in this respect, as surprisingly few studies have attempted to quantify the impact of COPD on the healthcare system and society in other countries. In an attempt to address the need for information on the burden of COPD, an economic analysis of data from a large-scale international survey, Confronting COPD in North America and Europe, was conducted in Canada and six other countries. The results of the Canadian survey estimated the direct cost of the disease at CA dollar 1997.81 per patient, with over half of this due to inpatient hospitalizations. COPD also had an impact on the economy, with indirect costs amounting to CA dollar 1198.18, a third of the total per patient cost of COPD to society (CA dollar 3195.97). Reducing the impact of this disease will necessitate improvements to the way the disease is managed in primary care, as poor symptom control and frequent exacerbations are key drivers of hospital and other unscheduled care costs. Early diagnosis and the application of available but underused interventions (e.g. smoking cessation, inhaled drug therapies and pulmonary rehabilitation) could reduce the morbidity and costs of COPD in this country.

摘要

慢性阻塞性肺疾病(COPD)是一种以进行性气流受限为特征的疾病,伴有呼吸困难、咳嗽和咳痰症状。除了加拿大COPD的患病率、死亡率及医院资源利用情况的相关信息外,关于该疾病对初级保健医疗资源利用的影响以及疾病经济负担(即直接和间接成本)的数据却很缺乏。在这方面,加拿大并非个例,因为令人惊讶的是,很少有研究试图量化COPD对其他国家医疗系统和社会的影响。为了满足对COPD负担信息的需求,在加拿大和其他六个国家对一项大型国际调查“北美和欧洲直面COPD”的数据进行了经济分析。加拿大调查结果估计,该疾病每位患者的直接成本为1997.81加元,其中一半以上是由于住院治疗。COPD对经济也有影响,间接成本达1198.18加元,占COPD对社会每位患者总成本(3195.97加元)的三分之一。要减轻这种疾病的影响,就必须改进初级保健中该疾病的管理方式,因为症状控制不佳和频繁发作是医院及其他非计划护理成本的关键驱动因素。早期诊断并应用现有的但未充分利用的干预措施(如戒烟、吸入药物治疗和肺康复)可以降低该国COPD的发病率和成本。

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