Unidad de Reumatología, Instituto Provincial de Rehabilitación, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Clin Exp Rheumatol. 2009 Sep-Oct;27(5 Suppl 56):S39-45.
Fibromyalgia (FM) patients have been regarded as great utilizers of health resources, with important related costs. The aim of this study is to describe health care resource utilisation and related costs of FM from the perspective of the National Health System in Spain.
A cross-sectional multicenter study was conducted on FM patients based on a patient interview. Data about demographic and clinical variables, physical examination, self-perceived health, psychosocial variables and health resource utilisation, were collected. Direct and indirect costs were calculated, and a correlational study between costs and clinical variables was performed.
Three-hundred and one patients were studied. During the year 2006 the mean total cost per patient per year was 9,982 Euros, of which 3,245.8 (32.5%) corresponded to health care costs and 6,736.2 (67.5%) to indirect costs attributable to productivity losses. Non-drug therapies accounted for the largest proportion of the health care costs, three times greater than the drug treatment. Patients with higher total costs showed the greatest disease involvement. The variables associated to the total health care costs were functional capacity, depression, comorbidities and age. Patients with permanent working disability were the greatest resource utilizers.
FM patients with higher costs show the greatest disease involvement. Direct and indirect costs are well correlated to disease severity. The indirect costs account for most of the economic burden of FM and approximately double the health care costs. Patients with permanent working disability present more severe disease and generate greater health care costs.
纤维肌痛（FM）患者被认为是大量利用卫生资源的人群，存在重要的相关费用。本研究旨在从西班牙国家卫生系统的角度描述 FM 患者的卫生保健资源利用情况和相关费用。
对基于患者访谈的 FM 患者进行了一项横断面多中心研究。收集了人口统计学和临床变量、体格检查、自我感知健康、心理社会变量以及卫生资源利用的数据。计算了直接和间接费用，并对费用与临床变量之间的相关性进行了研究。
共研究了 301 名患者。2006 年，每位患者每年的平均总费用为 9982 欧元，其中 3245.8 欧元（32.5%）为卫生保健费用，6736.2 欧元（67.5%）为因生产力损失导致的间接费用。非药物治疗占卫生保健费用的比例最大，是药物治疗的三倍。总费用较高的患者表现出更大的疾病负担。与总卫生保健费用相关的变量是功能能力、抑郁、合并症和年龄。有永久性工作残疾的患者是最大的资源利用者。
费用较高的 FM 患者表现出更大的疾病负担。直接和间接费用与疾病严重程度密切相关。间接费用占 FM 经济负担的大部分，约为卫生保健费用的两倍。有永久性工作残疾的患者疾病更严重，产生的卫生保健费用更高。
