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[以视网膜疾病为例估算疾病个人成本的方法]

[Methods for estimating personal costs of disease using retinal diseases as an example].

作者信息

Porz G, Scholl H P N, Holz F G, Finger R P

机构信息

Universitäts-Augenklinik Bonn, Deutschland.

出版信息

Ophthalmologe. 2010 Mar;107(3):216-20, 222. doi: 10.1007/s00347-009-2036-8.

Abstract

PURPOSE

Age-related macular degeneration (AMD) and other retinal diseases, such as diabetic retinopathy (DRP) and hereditary retinal dystrophy can not only lead to a loss of visual function but also to a higher psychological and financial burden for the affected persons. Against this background a quantification of personal cost and vision-related quality of life was performed.

METHODS

A total of 66 patients (mean age 69 years, SD 13 years) with clinically confirmed diagnoses of AMD, DRP or retinal dystrophy were interviewed regarding costs for medicines, aids and equipment, support in everyday life and social benefits. Vision-related quality of life was recorded using the Impact of Vision Impairment profile (IVI).

RESULTS

The average total annual cost was 751 per patient, out of which the largest amount was cost of support in everyday life (506). Costs as well as dependence on other persons or social services increased with decreasing visual acuity (p=0.013). Vision-related quality of life decreased with increasing visual disability especially in the IVI subscales mobility and independence as well as reading and accessing information (p=0.002).

CONCLUSIONS

Prevention or delay of visual disability and blindness caused by AMD or other retinal diseases and thus ensuring independence is not only relevant from a medical perspective but also from a health economic perspective. Against the background of a relative shortage of resources, costs should be reduced regardless of whether they are personal or societal costs.

摘要

目的

年龄相关性黄斑变性(AMD)以及其他视网膜疾病,如糖尿病性视网膜病变(DRP)和遗传性视网膜营养不良,不仅会导致视功能丧失,还会给患者带来更高的心理和经济负担。在此背景下,对个人成本和与视力相关的生活质量进行了量化。

方法

对66例临床确诊为AMD、DRP或视网膜营养不良的患者(平均年龄69岁,标准差13岁)进行访谈,了解药物、辅助器具和设备、日常生活支持及社会福利方面的费用。使用视力损害影响量表(IVI)记录与视力相关的生活质量。

结果

每位患者每年的平均总费用为751欧元,其中最大的费用是日常生活支持费用(506欧元)。随着视力下降,费用以及对他人或社会服务的依赖程度增加(p = 0.013)。与视力相关的生活质量随着视力残疾程度的增加而下降,尤其是在IVI量表的活动能力和独立性以及阅读和获取信息方面(p = 0.002)。

结论

预防或延缓由AMD或其他视网膜疾病导致的视力残疾和失明,从而确保独立性,不仅从医学角度来看很重要,从卫生经济学角度来看也很重要。在资源相对短缺的背景下,无论个人成本还是社会成本,都应予以降低。

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