Runge C, Grunze H
Abteilung Gesundheitsökonomie, GlaxoSmithKline GmbH and Co. KG, München, Deutschland.
Nervenarzt. 2004 Sep;75(9):896-903. doi: 10.1007/s00115-004-1691-x.
With costs of approximately 5.8 billion EUR annually, bipolar disorders represent a substantial burden on German society. The costs are mainly due to high indirect costs caused by morbidity-related unemployment, suicide-related losses of productivity, time off from work, and early retirement. Inpatient care, with a considerable average length of stay for patients with bipolar disorders, accounts for two-thirds of direct costs. This paper refers to statistics on use of healthcare services based primarily on the International Statistical Classification of Diseases, Tenth Revision. Representing a relatively narrow definition of bipolar disorders in comparison with the clinically relevant spectrum, this classification leads to a conservative estimate of the total costs. The significant lag between first acute episode and a correct diagnosis causes a delayed onset of maintenance treatment that leads to increased costs. Increasing public awareness, destigmatizing the disease, and educating physicians are necessary steps to limit the substantial economic burden for society.
双相情感障碍每年给德国社会造成约58亿欧元的成本负担,是一项沉重的负担。这些成本主要是由与发病相关的失业、与自杀相关的生产力损失、休假和提前退休所导致的高额间接成本造成的。双相情感障碍患者平均住院时间较长,住院护理占直接成本的三分之二。本文主要参考基于《国际疾病分类第十次修订本》的医疗服务使用统计数据。与临床相关范围相比,该分类对双相情感障碍的定义相对狭窄,导致对总成本的估计较为保守。首次急性发作与正确诊断之间的显著延迟导致维持治疗开始延迟,从而增加了成本。提高公众意识、消除对该疾病的污名化以及对医生进行教育是减轻社会巨大经济负担的必要措施。