Davidson Peter J, Sheerin Ian G, Frampton Chris
CURT Medical Trials Trust, St Georges Medical Centre, Christchurch, New Zealand.
N Z Med J. 2009 Jun 19;122(1297):57-67.
To quantify the annual burden of a 12-month cohort of newly diagnosed renal stones in the defined community of Christchurch, New Zealand, and to assess this burden by stone size and position.
In this prospective study of stone burden, patients in the Christchurch region of New Zealand with newly diagnosed renal stones maintained a weekly diary for a 12-month period to record the utilisation of health services and financial and social costs to families and partners. Patient records were matched with diagnostic and clinical information to provide a comprehensive database. The economic costs of the various services were estimated.
From November 2001 to November 2002, 422 newly diagnosed renal stones were detected--an annual incidence of 105 per 100,000 population. The annual mean cost of these stones was NZ$4274 per person in the first 12 months. The greatest costs were those for emergency visits, hospitalisations and for operative procedures (23.8%, 22.7%, and 21.8% of total financial burden respectively). Patient workdays lost accounted for 10.9% of total costs. Ureteric stones caused greater social burden than kidney stones. Costs were influenced by stone location and size, being significantly higher for ureteric stones and for larger stones.
Renal stone disease places a considerable burden on the community. The main burdens were related to health service costs, with personal and pharmaceutical costs representing only a small component. The financial burden to society is estimated at $450,000 per 100,000 population ($NZ in 2001/02).
量化新西兰克赖斯特彻奇特定社区中一组新诊断出的肾结石患者12个月期间的年度负担,并按结石大小和位置评估这一负担。
在这项关于结石负担的前瞻性研究中,新西兰克赖斯特彻奇地区新诊断出肾结石的患者在12个月期间每周记录日记,以记录医疗服务的使用情况以及家庭和伴侣的经济和社会成本。将患者记录与诊断和临床信息相匹配,以提供一个综合数据库。估算了各项服务的经济成本。
从2001年11月到2002年11月,共检测到422例新诊断出的肾结石——年发病率为每10万人中有105例。这些结石在最初12个月里人均年度平均成本为4274新西兰元。最大的成本是急诊就诊、住院和手术费用(分别占总经济负担的23.8%、22.7%和21.8%)。患者损失的工作日占总成本的10.9%。输尿管结石造成的社会负担比肾结石更大。成本受结石位置和大小的影响,输尿管结石和较大结石的成本明显更高。
肾结石疾病给社区带来了相当大的负担。主要负担与医疗服务成本相关,个人和药物成本仅占一小部分。据估计,每10万人口给社会造成的经济负担为45万新西兰元(2001/02年度)。