Cubo E, Martínez Martin P, González M, Frades B
Departamento de Epidemiologia Aplicada, Instituto de Salud Carlos III, Madrid.
Neurologia. 2009 Jan-Feb;24(1):15-23.
We evaluate the health-related economic burden of patients with Parkinson's disease (PD) and identify the impact of motor and nonmotor symptoms (NMS) and health-related quality of life (HRQL) on the direct costs of PD in Spain.
A cross-sectional, multicenter, pilot study covering consecutive PD outpatients who were included during the year 2004. Cognition (MMSE, SCOPA-Cog), autonomic dysfunction (SCOPA-AUT), motor impairment, severity and complications (SCOPA-motor), depression/anxiety (HADS), sleep (PDSS), psychosis (PPRS), pain, severity/global impairment (HY staging and CISI-PD) and health-related quality of life (EuroQoL) were evaluated. PD-related cost data were obtained using a standardized questionnaire. Association of clinical variables with direct costs was analyzed using the parametric and nonparametric tests.
Seventy-eight consecutive PD outpatients (52% female and 48% male) having a mean age of 68.2 years (SD: 11), median HY stage of 2 (1-5), and mean PD duration of 8.3 years (SD: 5.4) were included in this study. Average 3 month total direct cost of PD was euro 2,631 (SD: 4507) per person (range: euro 71.5-euro 29,159) and medical treatment was the main cost driver, accounting for 34 % (mean drug cost per person euro 669; SD: 406). PD direct costs were significantly higher among younger patients, with higher HY stage, PD duration, severity, motor impairment and motor complications (p<0.05).
Disease severity, motor impairment and complications had a higher impact on the direct costs of PD than NMS.
我们评估帕金森病（PD）患者与健康相关的经济负担，并确定运动和非运动症状（NMS）以及健康相关生活质量（HRQL）对西班牙PD直接成本的影响。
一项横断面、多中心的试点研究，涵盖2004年纳入的连续PD门诊患者。评估了认知（MMSE、SCOPA-Cog）、自主神经功能障碍（SCOPA-AUT）、运动障碍、严重程度和并发症（SCOPA-运动）、抑郁/焦虑（HADS）、睡眠（PDSS）、精神病（PPRS）、疼痛、严重程度/整体损伤（HY分期和CISI-PD）以及健康相关生活质量（欧洲生活质量量表）。使用标准化问卷获取与PD相关的成本数据。使用参数检验和非参数检验分析临床变量与直接成本的关联。
本研究纳入了78例连续的PD门诊患者（女性52%，男性48%），平均年龄68.2岁（标准差：11），HY分期中位数为2（1 - 5），平均PD病程8.3年（标准差：5.4）。PD患者平均3个月的总直接成本为每人2631欧元（标准差：4507）（范围：71.5欧元 - 29159欧元），医疗治疗是主要的成本驱动因素，占34%（人均药物成本669欧元；标准差：406）。年轻患者、HY分期较高、PD病程较长、病情严重程度较高、运动障碍和运动并发症较多的患者，其PD直接成本显著更高（p<0.05）。
疾病严重程度、运动障碍和并发症对PD直接成本的影响高于非运动症状。
