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中国脑瘫经济负担的初步研究。

A preliminary study into the economic burden of cerebral palsy in China.

作者信息

Wang Bin, Chen Yingyao, Zhang Jie, Li Jun, Guo Yan, Hailey David

机构信息

School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China.

出版信息

Health Policy. 2008 Aug;87(2):223-34. doi: 10.1016/j.healthpol.2008.01.001. Epub 2008 Feb 20.

Abstract

OBJECTIVES

To measure the economic burden of cerebral palsy (CP) in China is to provide information on CP's societal impacts to policy-makers.

METHODS

The economic burden of CP includes direct healthcare costs, direct non-healthcare costs, developmental costs and indirect costs such as productivity loss. The incidence approach is employed to estimate the lifetime economic burden of a new CP birth and that of all new cases in China in 2003. Caregivers of 319 CP patients were interviewed in specialty hospitals in five cities in 2004. Average expenditure and utilization rates for different services by age groups from this sample were obtained to estimate the economic burden of CP. Chinese CP patients' life expectancy and survival rate were simulated with reference to Australian data with Human Development Index adjustment.

RESULTS

From the societal perspective, the average lifetime economic burden of a new CP case in China was US$ 67,044 in 2003, and the life-span total economic loss due to all new CP cases in 2003 amounted to US$ 2-4 billion. Indirect (productivity) costs are responsible for 93% of total economic loss, and direct healthcare and developmental costs make up 3% each. There are several factors which contribute to the extraordinarily high economic burden of CP, including productivity loss, reduced life expectancy, dependency, progressive deterioration of motor physical function, and recurrent use of rehabilitation services.

CONCLUSION

The economic burden of CP in China is substantial for the family of a CP patient, as well as to society. Public provision and financing of necessary preventive and rehabilitative services is urgently needed to mitigate this heavy burden for patients and their families.

摘要

目的

衡量中国脑瘫(CP)的经济负担,以便向政策制定者提供有关脑瘫对社会影响的信息。

方法

脑瘫的经济负担包括直接医疗费用、直接非医疗费用、发育费用以及间接费用,如生产力损失。采用发病率法估算2003年中国新出生脑瘫患儿以及所有新发病例的终身经济负担。2004年,对五个城市专科医院的319名脑瘫患者的照料者进行了访谈。从该样本中获取不同年龄组各类服务的平均支出和利用率,以估算脑瘫的经济负担。参照澳大利亚数据并经人类发展指数调整后,模拟了中国脑瘫患者的预期寿命和生存率。

结果

从社会角度来看,2003年中国新发病例的平均终身经济负担为67,044美元,2003年所有新发病例导致的终身总经济损失达20亿至40亿美元。间接(生产力)成本占总经济损失的93%,直接医疗和发育成本各占3%。导致脑瘫经济负担异常高昂的因素有多个,包括生产力损失、预期寿命缩短、依赖他人、运动身体功能逐渐恶化以及康复服务的反复使用。

结论

中国脑瘫的经济负担对患者家庭以及社会而言都十分巨大。迫切需要公共提供并资助必要的预防和康复服务,以减轻患者及其家庭的沉重负担。

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