Kapur Anil
World Diabetes Foundation, Lyngby, Denmark.
Indian J Med Res. 2007 Mar;125(3):473-82.
Many socio-economic factors and health care system related issues impact the outcome of diabetes and consequently its costs and vice versa. Factors that influence delay in diagnosis also determine complication rates and thus costs. Presence and severity of complications as well as co-morbid conditions are the most important determinants of treatment and monitoring regimen as well as the need for hospitalization and are therefore important factors related to costs. The average annual direct costs of hospitalized patients are more than double to those not hospitalized. Complications are also responsible for indirect costs in terms of productivity loss and absenteeism. Our studies show that the cost of providing routine care is only a fraction of the overall costs and is perhaps still manageable; however when this is not available or its quality is poor the overall direct and indirect costs, escalate with disastrous health and economic consequences to the individual, his family and society. Effective intervention means prevention both primary (health promotion and awareness) as well as secondary prevention (reducing the burden of complications by early diagnosis and effective care). Everyone involved in diabetes care need to be aware of what drives cost: proper effective treatment of diabetes is not but not treating diabetes or treating it ineffectively is very costly.
许多社会经济因素和与医疗保健系统相关的问题会影响糖尿病的治疗结果,进而影响其成本,反之亦然。影响诊断延迟的因素也决定了并发症发生率,从而决定了成本。并发症的存在和严重程度以及合并症是治疗和监测方案以及住院需求的最重要决定因素,因此也是与成本相关的重要因素。住院患者的年均直接成本比未住院患者高出一倍多。并发症还会导致生产力损失和旷工方面的间接成本。我们的研究表明,提供常规护理的成本只是总成本的一小部分,或许仍可控制;然而,当无法提供常规护理或其质量较差时,总体直接和间接成本就会上升,给个人、其家庭和社会带来灾难性的健康和经济后果。有效的干预意味着一级预防(健康促进和提高认识)以及二级预防(通过早期诊断和有效护理减轻并发症负担)。参与糖尿病护理的每个人都需要了解成本的驱动因素:正确有效地治疗糖尿病成本不高,但不治疗糖尿病或治疗不当则成本高昂。