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荷兰中风的未来成本:中风服务的影响。

Future costs of stroke in the Netherlands: the impact of stroke services.

作者信息

Struijs Jeroen N, van Genugten Marianne L L, Evers Silvia M A A, Ament André J H, Baan Caroline A, van den Bos Geertrudis A M

机构信息

Centre for Prevention and Health Services Research, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.

出版信息

Int J Technol Assess Health Care. 2006 Fall;22(4):518-24. doi: 10.1017/S0266462306051464.

Abstract

OBJECTIVES

In the next decades, the number of stroke patients is expected to increase. Furthermore, organizational changes, such as stroke services, are expected to be implemented on a large scale. The purpose of this study is to estimate the future healthcare costs by taking into account the expected increase of stroke patients and a nationwide implementation of stroke services.

METHODS

By means of a dynamic multistate life table, the total number of stroke patients can be projected. The model calculates the annual number of patients by age and gender. The total healthcare costs are calculated by multiplying the average healthcare costs specified by age, gender, and healthcare sector with the total number of stroke patients specified by age and gender.

RESULTS

In the year 2000, the healthcare costs for stroke amounted to euro 1.62 billion. This amount is approximately 4.4 percent of the total national healthcare budget. Projections of the total costs of stroke based on current practice result in an increase of 28 percent (euro 2.08 billion) in the year 2020. A nationwide implementation of stroke services in 2020 would result in a substantial reduction of the costs of stroke (euro 1.81 billion: 13 percent cost reduction) compared with the regular care scenario.

CONCLUSIONS

A nationwide implementation of stroke services is a strong policy tool for cost containment of health care in an aging population like that in the Netherlands. Policy makers should optimize the organization of stroke care.

摘要

目标

在未来几十年,中风患者数量预计将会增加。此外,诸如中风服务等组织变革预计将大规模实施。本研究的目的是通过考虑中风患者数量的预期增长以及中风服务在全国范围内的实施情况,来估算未来的医疗保健成本。

方法

借助动态多状态生命表,可以预测中风患者的总数。该模型按年龄和性别计算每年的患者数量。通过将按年龄、性别和医疗保健部门规定的平均医疗保健成本与按年龄和性别规定的中风患者总数相乘,来计算总的医疗保健成本。

结果

2000年,中风的医疗保健成本达16.2亿欧元。这一金额约占国家医疗保健预算总额的4.4%。根据当前做法对中风总成本的预测显示,到2020年成本将增加28%(达20.8亿欧元)。与常规护理方案相比,2020年在全国范围内实施中风服务将大幅降低中风成本(18.1亿欧元:成本降低13%)。

结论

在荷兰这样老龄化的人口中,在全国范围内实施中风服务是控制医疗保健成本的有力政策工具。政策制定者应优化中风护理的组织。

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