Happich Michael, John Jürgen, Stamenitis Sabine, Clouth Johannes, Polnau Dorit
Lilly Deutschland GmbH, Saalburgerstr. 153, 61350 Bad Homburg, Germany.
Diabetes Res Clin Pract. 2008 Aug;81(2):223-30. doi: 10.1016/j.diabres.2008.03.019. Epub 2008 Jul 7.
To describe the health-related quality of life (HRQOL), the resource utilization and annual costs associated with diabetic neuropathy (DN) in Germany.
In this retrospective, observational study German internists, diabetologists and general practitioners provided information on 185 adult type 1 and type 2 diabetic patients with DN. Health-related quality of life (HRQOL) was assessed using generic and disease specific questionnaires. Socio-demographic and resource use data were assessed from medical charts and through patient interviews. Based on these results, national-level cost estimates were calculated using German unit costs.
The majority of DN patients were severely impaired with regard to general physical HRQOL. Disease specific HRQOL decreased continuously with increasing DN severity. In accordance, costs associated with DN increased as DN progressed, with costs from the societal perspective increasing about 50-fold from the lowest severity stage (patients with sensory-motor neuropathy without symptoms) (euro431) to patients with lower extremity amputation in the year 2002 (euro21,476). The German statutory health insurance covered more than two thirds of the total costs of DN.
The results described in this report show that diabetic neuropathy in adults with type 1 or type 2 diabetes generates significant reductions in the patient's quality of life and a substantial economic burden both for society and health insurance.
描述德国糖尿病神经病变(DN)患者的健康相关生活质量(HRQOL)、资源利用情况及年度成本。
在这项回顾性观察研究中,德国的内科医生、糖尿病专家和全科医生提供了185例1型和2型糖尿病成年DN患者的信息。使用通用问卷和疾病特异性问卷评估健康相关生活质量(HRQOL)。通过病历和患者访谈评估社会人口统计学和资源使用数据。基于这些结果,使用德国单位成本计算国家级成本估算。
大多数DN患者的总体身体HRQOL严重受损。疾病特异性HRQOL随着DN严重程度的增加而持续下降。相应地,随着DN的进展,与DN相关的成本增加,从社会角度来看,成本从最低严重程度阶段(无症状的感觉运动神经病变患者)(431欧元)到2002年下肢截肢患者(21,476欧元)增加了约50倍。德国法定医疗保险覆盖了DN总成本的三分之二以上。
本报告所述结果表明,1型或2型糖尿病成年患者的糖尿病神经病变会显著降低患者的生活质量,并给社会和医疗保险带来巨大经济负担。