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老年慢性阻塞性肺疾病的经济负担:文献系统评价的结果。

The economic burden of chronic obstructive pulmonary disease in the elderly: results from a systematic review of the literature.

机构信息

Scientific Direction, Italian National Research Center on Aging (I.N.R.C.A.), Ancona, Italy.

出版信息

Curr Opin Pulm Med. 2011 Dec;17 Suppl 1:S35-41. doi: 10.1097/01.mcp.0000410746.82840.79.

Abstract

PURPOSE OF REVIEW

Chronic obstructive pulmonary disease (COPD) is a high prevalence condition with a significant clinical and economic burden. In elderly people, COPD is often associated with other chronic comorbidities (i.e. cardiovascular diseases), determining clinical complications and requiring frequent acute healthcare interventions. The aim of this article is to review the economic studies evaluating costs and healthcare resource utilization in elderly (≥ 65 years) COPD patients.

RECENT FINDINGS

Sixteen of the initial 359 articles retrieved through our research strategy were found to include relevant cost information on elderly COPD patients or to evaluate the effect of older age on healthcare expenditure. Most studies were carried out in the United States and used administrative database claims to determine resource consumption and direct costs (attributable and not). Very few studies focused exclusively on elderly patients.

SUMMARY

Results showed a certain variability of cost estimations, mainly due to the different methodologies and adopted cost approach. However, we found a trend of direct cost growth in the elderly population, which can be explained by a more frequent use of acute healthcare services, especially for managing COPD exacerbations. These results cannot be considered definitive and new studies, targeting elderly people, are required in order to confirm these preliminary findings.

摘要

目的综述

慢性阻塞性肺疾病(COPD)是一种高患病率疾病,具有显著的临床和经济负担。在老年人中,COPD 常与其他慢性合并症(如心血管疾病)相关,导致临床并发症,并需要频繁的急性医疗保健干预。本文旨在综述评估老年(≥65 岁)COPD 患者的成本和医疗资源利用的经济研究。

最近的发现

通过我们的研究策略,从最初的 359 篇文章中检索到了 16 篇,这些文章包含有关老年 COPD 患者成本信息或评估年龄对医疗支出的影响。大多数研究在美国进行,并使用行政数据库的索赔来确定资源消耗和直接成本(归因和非归因)。很少有研究专门针对老年患者。

总结

结果显示成本估算存在一定的可变性,主要是由于不同的方法学和采用的成本方法。然而,我们发现老年人群的直接成本呈增长趋势,这可以通过更频繁地使用急性医疗保健服务来解释,特别是用于管理 COPD 加重。这些结果不能被认为是确定的,需要针对老年人进行新的研究,以证实这些初步发现。

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