Riddell Steven, Shanahan Marian, Degenhardt Louisa, Roxburgh Amanda
The National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Aust N Z J Public Health. 2008 Apr;32(2):156-61. doi: 10.1111/j.1753-6405.2008.00193.x.
To estimate the total hospital costs of drug-related separations in Australia from 1999/2000 to 2004/05, and separate costs for the following illicit drug classes: opioids, amphetamine, cannabis and cocaine.
Australian hospital separations between 1999/2000 to 2004/05 from the National Hospital Morbidity Dataset (NHMD) with a principal diagnosis of opioids, amphetamine, cannabis or cocaine were included, as were indirect estimates of additional 'drug-caused' separations using aetiological fractions. The costs were estimated using the year-specific case weights and costs for each respective Diagnostic Related Group (DRG).
Total constant costs decreased from $50.8 million in 1999/2000 to $43.8 million in 2002/03 then increased to $46.7 million in 2004/05. The initial decrease was driven by a decline in numbers of opioid-related separations (with costs decreasing by $11.5 million) between 1999/2000 and 2001/02. Decreases were evident in separations within the opioid use, dependence and poisoning DRGs. Increases in costs were observed between 1999/00 and 2004/05 for amphetamine (an increase of $2.4 million), cannabis ($1.8 million) and cocaine ($330,000) related separations. Several uncommon but very expensive drug-related separations constituted 12.7% of the total drug-related separations.
Overall, the costs of drug-related hospital separations have decreased by $4.1 million between 1999 and 2005, which is primarily attributable to fewer opioid-related separations. Small reductions in the number of costly separations through harm reduction strategies have the potential to significantly reduce drug-related hospital costs.
估算1999/2000年至2004/05年澳大利亚与药物相关的住院费用,以及以下非法药物类别的单独费用:阿片类药物、苯丙胺、大麻和可卡因。
纳入1999/2000年至2004/05年澳大利亚国家医院发病率数据集(NHMD)中主要诊断为阿片类药物、苯丙胺、大麻或可卡因的住院病例,以及使用病因学分数对额外“药物导致”住院病例的间接估计。费用使用各年份特定的病例权重和每个相应诊断相关组(DRG)的费用进行估算。
固定费用总额从1999/2000年的5080万美元降至2002/03年的4380万美元,然后在2004/05年增至4670万美元。最初的下降是由1999/2000年至2001/02年期间与阿片类药物相关的住院病例数减少(费用减少1150万美元)导致的。在阿片类药物使用、依赖和中毒DRG内的住院病例数明显减少。1999/00年至2004/05年期间,与苯丙胺相关的住院病例费用增加了240万美元,大麻相关的增加了180万美元,可卡因相关 的增加了33万美元。一些罕见但费用很高的与药物相关的住院病例占与药物相关住院病例总数的12.7%。
总体而言,1999年至2005年期间,与药物相关的住院费用减少了410万美元,这主要归因于与阿片类药物相关的住院病例减少。通过减少伤害策略小幅减少高费用住院病例数有可能显著降低与药物相关的住院费用。