Huse Daniel M, Schulman Kathy, Orsini Lucinda, Castelli-Haley Jane, Kennedy Sean, Lenhart Gregory
Thomson Medstat, Cambridge, Massachusetts 02140, USA.
Mov Disord. 2005 Nov;20(11):1449-54. doi: 10.1002/mds.20609.
This study quantifies direct medical care costs for individual patients with Parkinson's disease (PD) and projects total national costs of PD. Anonymous, patient-level data on health care utilization and cost were obtained from Medstat's MarketScan Research Databases. Patients were selected for study if they had either two instances of a diagnosis of PD or one diagnosis and two or more prescriptions for PD-related medication. A control group of persons without PD was selected for comparison. Total annual health care utilization and costs were calculated for both PD patients and controls. A total of 20,016 patients with PD were identified and followed up for an average of 853 days. The mean age of the patients was 73.6 years, and 51.2% were women. Total annual direct costs were 23,101 US Dollars (SD 27,529) per patient with PD versus 11,247 US Dollars (SD 16,486) for controls. The regression-adjusted incremental direct cost of PD versus control was 10,349 US Dollars (95% confidence interval, 9,053, 11,645). Adding 25,326 US Dollars in indirect costs, and multiplying by 645,000 cases of PD in the United States, the total cost to the nation is projected to be 23 billion US Dollars annually. This estimate is higher than most previous studies, with important implications for health care delivery systems worldwide.
本研究对帕金森病（PD）个体患者的直接医疗费用进行了量化，并预测了全国PD的总费用。关于医疗保健利用和费用的匿名患者层面数据来自Medstat的市场扫描研究数据库。如果患者有两次PD诊断记录，或者有一次诊断记录且有两种或更多与PD相关药物的处方，则被选入研究。选取一组无PD的人作为对照组进行比较。计算了PD患者和对照组的年度医疗保健总利用量和费用。共识别出20,016例PD患者，并对其进行了平均853天的随访。患者的平均年龄为73.6岁，51.2%为女性。PD患者的年度直接费用为每人23,101美元（标准差27,529美元），而对照组为11,247美元（标准差16,486美元）。与对照组相比，经回归调整后的PD增量直接成本为10,349美元（95%置信区间为9,053至11,645美元）。加上25,326美元的间接成本，并乘以美国的645,000例PD病例，预计全国每年的总成本为230亿美元。这一估计高于大多数先前的研究，对全球医疗保健提供系统具有重要意义。
