Ecoplan, Economic Research and Policy Consultancy, Bern, Switzerland.
Swiss Med Wkly. 2010 Sep 10;140:w13093. doi: 10.4414/smw.2010.13093. eCollection 2010.
The aim of this study was (a) to estimate the cost of dementia in Switzerland, (b) to compare the average annual cost for people with dementia who live at home and those living in an institution and (c) to analyse how the average cost per person with dementia who lives at home increases with the severity of dementia.
This prevalence-based cost-of-illness study from a societal perspective combined top-down and bottom-up approaches and included both direct and indirect costs of dementia. Cost estimations were based on Swiss national statistics and surveys, as well as international reviews and expert interviews.
The total annual cost of dementia amounted up to CHF 6.3 billion for the year 2007. Together, institutional and informal care accounted for over 90% of the cost. The average annual cost was estimated at CHF 55'300 per person with dementia who lives at home and at CHF 68'900 per person who lives in an institution. The cost per person living at home with severe dementia was nearly five times the cost per person with mild dementia.
The present study indicates that dementia imposes a considerable economic burden on Swiss society. The cost of dementia is dominated by the costs of care. Diagnosis and treatment related costs are minor. These findings are consistent with contemporary international studies on the subject. The contribution of informal caregivers is substantial since they account for 44% of the total cost of dementia (based on market cost valuation). Given demographic developments in Switzerland, healthcare decision making should have an interest in securing this potential for the future.
本研究旨在:(a) 估算瑞士痴呆症的成本;(b) 比较居家和机构护理的痴呆症患者的平均年费用;(c) 分析居家痴呆症患者的人均费用如何随疾病严重程度的增加而增加。
本项基于患病率的疾病成本研究从社会角度出发,结合自上而下和自下而上的方法,包括痴呆症的直接和间接成本。成本估算基于瑞士国家统计数据和调查以及国际综述和专家访谈。
2007 年痴呆症的总年度成本达到 63 亿瑞士法郎。机构和非正规护理共同占总成本的 90%以上。居家痴呆症患者的年平均费用估计为 55300 瑞士法郎,而机构内患者的费用为 68900 瑞士法郎。居家严重痴呆症患者的人均费用几乎是轻度痴呆症患者的五倍。
本研究表明,痴呆症给瑞士社会带来了相当大的经济负担。痴呆症的成本主要由护理成本决定。诊断和治疗相关成本较小。这些发现与当代国际研究结果一致。鉴于瑞士人口结构的发展,医疗保健决策应该有兴趣为未来保障这一潜力。