Croatian Society for Pharmacoeconomics and Health Economics, Zagreb, Croatia.
Croatian Centre for Global Health, University of Split School of Medicine, Split, Croatia.
Clin Nutr. 2014 Aug;33(4):689-93. doi: 10.1016/j.clnu.2013.09.006. Epub 2013 Sep 18.
BACKGROUND & AIMS: Undernutrition is a common and aggravating problem in people suffering from various chronic diseases as well as a source of material costs. The aim of this study was to investigate the prevalence of disease-related undernutrition among adults in Croatia in the year 2012, as well as the cost of undernutrition associated with tumour cachexia, chronic pancreatitis, inflammatory bowel disease, hepatic encephalopathy, chronic obstructive pulmonary disease, chronic renal insufficiency requiring dialysis, cerebrovascular insult, pressure ulcers, and femoral fractures in the elderly.
A cost-of-illness analysis was conducted, including direct costs only. The study employed the dominant cost-of-illness method, which restricts the summation of medical expenditure to the disease of interest. The bottom-up, prevalence-based approach was used. The budget holder perspective was employed, and data sources include the list of reimbursed drugs, clinical opinions, and literature.
The prevalence of disease-related undernutrition in people over the age of 20 in Croatia in the year 2012 was estimated to be 33.7/1000. The total cost of adult malnutrition for selected diagnoses was 97.35 million EUR, accounting for 3.38% of the total Croatian national health care budget. The largest share was used for medications (43%), followed by 34% for hospitalizations, 13% for community health nursing, while parenteral and enteral nutrition contributed with 6% and 1% respectively. The average cost per patient was estimated at 1640.48 EUR.
The cost of malnutrition for the selected diagnoses in Croatia was substantial. These health costs will increase due to population ageing, which calls for undernutrition screening in people at risk as well as for effective approaches in nutrition supplementation.
营养不良是患有各种慢性疾病的人群中常见且日益严重的问题，也是造成物质成本的一个因素。本研究旨在调查 2012 年克罗地亚成年人中与疾病相关的营养不良的流行情况，以及肿瘤恶病质、慢性胰腺炎、炎症性肠病、肝性脑病、慢性阻塞性肺疾病、需要透析的慢性肾功能不全、脑血管意外、压疮和老年人股骨骨折相关的营养不良的成本。
进行了疾病成本分析，仅包括直接成本。本研究采用了优势成本疾病分析法，该方法将医疗支出的总和限制在相关疾病上。采用自下而上、基于流行率的方法。采用预算承担者视角，数据来源包括报销药物清单、临床意见和文献。
2012 年克罗地亚 20 岁以上人群中与疾病相关的营养不良的流行率估计为 33.7/1000。选定诊断的成人营养不良总成本为 9735 万欧元，占克罗地亚国家卫生保健总预算的 3.38%。最大的份额用于药物（43%），其次是住院治疗（34%）、社区保健护理（13%），而肠外和肠内营养分别贡献了 6%和 1%。每位患者的平均成本估计为 1640.48 欧元。
克罗地亚选定诊断的营养不良的健康成本相当大。由于人口老龄化，这些卫生成本将会增加，这需要对有风险的人群进行营养不良筛查，并采取有效的营养补充方法。
