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瑞典按疾病严重程度划分的 COPD 健康经济成本——这在十年期间发生了变化吗?

Health economic costs of COPD in Sweden by disease severity--has it changed during a ten years period?

机构信息

The OLIN Studies, Norrbotten County Council, Robertsviksgatan 9, SE-971 89 Luleå, Sweden; Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, SE-901 87 Umeå, Sweden.

出版信息

Respir Med. 2013 Dec;107(12):1931-8. doi: 10.1016/j.rmed.2013.07.012. Epub 2013 Aug 1.

DOI:10.1016/j.rmed.2013.07.012
PMID:23910072
Abstract

OBJECTIVES

The objectives of the presented study were to estimate societal costs of COPD in Sweden, the relationship between costs and disease severity, and possible changes in the costs during the last decade.

METHODS

Subjects with COPD derived from the general population in Northern Sweden were interviewed by telephone regarding their resource utilisation and productivity losses four times quarterly during 2009-10. Mean annual costs were estimated for each severity stage of COPD.

RESULTS

A strong relationship was found between disease severity and costs. Estimated mean annual costs per subject of mild, moderate, severe and very severe COPD amounted to 596 (SEK 5686), 3245 (SEK 30,957), 5686 (SEK 54,242), and 17,355 euros (SEK 165,569), respectively. The main cost drivers for direct costs were hospitalisations (for very severe COPD) and drugs (all other severity stages). The main cost driver for indirect costs was productivity loss due to sick-leave (for mild COPD) and early retirement (all other severity stages). Costs appeared to be lower in 2010 than in 1999 for subjects with severe and very severe COPD, but higher for those with mild and moderate COPD.

CONCLUSION

Our results show that costs of COPD are strongly related to disease severity, and scaling the data to the whole Swedish population indicates that the total costs in Sweden amounted to 1.5 billion euros (SEK 13.9 bn) in 2010. In addition, costs have decreased since 1999 for subjects with severe and very severe COPD, but increased for those with mild and moderate COPD.

摘要

目的

本研究旨在评估瑞典 COPD 的社会成本、成本与疾病严重程度的关系,以及过去十年成本的变化趋势。

方法

本研究通过电话对瑞典北部普通人群中的 COPD 患者进行了四次每季度一次的访谈,调查其资源利用和生产力损失情况。根据 COPD 的严重程度,估算每位患者的年平均成本。

结果

发现疾病严重程度与成本之间存在很强的相关性。轻度、中度、重度和极重度 COPD 患者的年平均估计成本分别为 596(瑞典克朗 5686)、3245(瑞典克朗 30957)、5686(瑞典克朗 54242)和 17355 欧元(瑞典克朗 165569)。直接成本的主要驱动因素是医院就诊(极重度 COPD)和药物(所有其他严重程度)。间接成本的主要驱动因素是因病假(轻度 COPD)和提前退休(所有其他严重程度)导致的生产力损失。与 1999 年相比,2010 年重度和极重度 COPD 患者的成本似乎有所降低,但轻度和中度 COPD 患者的成本有所增加。

结论

我们的研究结果表明,COPD 的成本与疾病严重程度密切相关,将数据扩展到整个瑞典人口,表明 2010 年瑞典 COPD 的总成本为 15 亿欧元(瑞典克朗 139 亿)。此外,与 1999 年相比,重度和极重度 COPD 患者的成本有所下降,但轻度和中度 COPD 患者的成本有所增加。

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