Esteghamati A, Khalilzadeh O, Anvari M, Meysamie A, Abbasi M, Forouzanfar M, Alaeddini F
Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Diabetologia. 2009 Aug;52(8):1520-7. doi: 10.1007/s00125-009-1398-4. Epub 2009 May 28.
AIM/HYPOTHESIS: The aim of the study was to determine the annual healthcare expenditures of an individual with diabetes in Tehran, between March 2004 and March 2005.
This prevalence-based 'cost-of-illness' study was conducted in two phases. In the first phase, 23,707 randomly selected individuals were interviewed to gather a cohort of participants with diabetes. In the second phase, 710 diabetic patients and 904 age- and sex-matched controls were followed up for 1 year at intervals of 3 months and the direct (physician services, medications and devices, hospitalisation, laboratory, paraclinical and transport) and indirect (loss of productivity) expenditures were recorded. The excess costs of a person with diabetes were estimated through comparison with matched controls. The estimates were also extrapolated to the total population of Tehran and Iran. The costs were converted from the Iranian rial to the US dollar (exchange rate September 2004).
Total annual direct costs of diabetic and control participants were $152.3 +/- 14.5 and $52.0 +/- 5.8, respectively, which is indicative of 2.92 times higher costs in diabetic patients. The most expensive components of direct costs were medications and devices, and hospitalisation in diabetic patients (28.7% and 28.6%, respectively). Total indirect costs were $39.6 +/- 2.4 and $16.7 +/- 1.1 in diabetic and non-diabetic individuals. The aggregate annual direct costs of diabetes were estimated to be $112.424 +/- 10.732 million and $590.676 +/- 65.985 million in Tehran and Iran, respectively. Diabetes complications contributed 53% of the aggregate excess direct costs of diabetes.
CONCLUSIONS/INTERPRETATION: Diabetes is an expensive medical problem in Iran and planning of national programmes for its control and prevention is necessary.
目的/假设：本研究的目的是确定2004年3月至2005年3月期间德黑兰一名糖尿病患者的年度医疗保健支出。
这项基于患病率的“疾病成本”研究分两个阶段进行。在第一阶段，对23707名随机选择的个体进行访谈，以收集一组糖尿病参与者。在第二阶段，对710名糖尿病患者和904名年龄和性别匹配的对照组进行为期1年的随访，每隔3个月进行一次，记录直接（医生服务、药物和设备、住院、实验室、辅助临床和交通）和间接（生产力损失）支出。通过与匹配的对照组比较，估计糖尿病患者的额外成本。这些估计值也外推到德黑兰和伊朗的总人口。成本从伊朗里亚尔换算成美元（2004年9月汇率）。
糖尿病患者和对照组参与者的年度直接成本分别为152.3±14.5美元和52.0±5.8美元，这表明糖尿病患者的成本高出2.92倍。直接成本中最昂贵的部分是糖尿病患者的药物和设备以及住院费用（分别为28.7%和28.6%）。糖尿病患者和非糖尿病个体的间接总成本分别为39.6±2.4美元和16.7±1.1美元。糖尿病的年度直接总成本估计在德黑兰为1.12424±1073.2万美元，在伊朗为5.90676±659.85万美元。糖尿病并发症占糖尿病总额外直接成本的53%。
结论/解读：糖尿病在伊朗是一个昂贵的医疗问题，因此有必要制定国家控制和预防计划。
