García-Contreras Fernando, Constantino-Casas Patricia, Castro-Ríos Angélica, Nevárez-Sida Armando, Estrada Correa Gloria del Carmen, Carlos Rivera Fernando, Guzmán-Caniupan Jorge, Torres-Arreola Laura del Pilar, Contreras-Hernández Iris, Mould-Quevedo Joaquin, Garduño-Espinosa Juan
Unidad de Investigación en Economía de la Salud, Instituto Mexicano del Seguro Social, México D.F., México.
Arch Med Res. 2006 Apr;37(3):376-83. doi: 10.1016/j.arcmed.2005.07.005.
The aim was to determine the direct medical costs in patients with partial refractory epilepsy at the Mexican Institute of Social Security (IMSS) in Mexico.
We carried out a multicenter, retrospective-cohort partial-economic evaluation study of partial refractory epilepsy (PRE) diagnosed patients and analyzed patient files from four secondary- and tertiary-level hospitals. PRE patients >12 years of age with two or more antiepileptic drugs and follow-up for at least 1 year were included. The perspective was institutional (IMSS). Only direct healthcare costs were considered, and the timeline was 1 year. Cost techniques were microcosting, average per-service cost, and per-day cost, all costs expressed in U.S. dollars (USD, 2004).
We reviewed 813 files of PRE patients: 133 had a correct diagnosis, and only 72 met study inclusion criteria. Fifty eight percent were females, 64% were <35 years of age, 47% were students, in 73% maximum academic level achieved was high school, and 53% were single. Fifty one percent of cases experienced simple partial seizures and 94% had more than one monthly seizure. Annual healthcare cost of the 72 patients was 190,486 USD, ambulatory healthcare contributing 76% and hospital healthcare with 24%.
Annual mean healthcare cost per PRE patient was 2,646 USD; time of disease evolution and severity of the patient's illness did not affect costs significantly.
目的是确定墨西哥社会保障局（IMSS）中部分难治性癫痫患者的直接医疗费用。
我们对诊断为部分难治性癫痫（PRE）的患者进行了一项多中心、回顾性队列部分经济评估研究，并分析了四家二级和三级医院的患者档案。纳入年龄大于12岁、使用两种或更多抗癫痫药物且随访至少1年的PRE患者。研究视角为机构视角（IMSS）。仅考虑直接医疗费用，时间范围为1年。成本核算技术包括微观成本核算、每项服务平均成本和每日成本，所有成本均以美元（2004年美元）表示。
我们审查了813份PRE患者档案：133例诊断正确，只有72例符合研究纳入标准。58%为女性，64%年龄小于35岁，47%为学生，73%的最高学历为高中，53%为单身。51%的病例出现简单部分性发作，94%的患者每月发作不止一次。72例患者的年度医疗费用为190,486美元，门诊医疗费用占76%，住院医疗费用占24%。
每位PRE患者的年度平均医疗费用为2,646美元；疾病演变时间和患者病情严重程度对费用没有显著影响。
