Chan Agnes L F, Cham Thau-Ming, Lin Shun-Jin
School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan ; Chi Mei Medical Center, Tainan, Taiwan.
School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
Curr Ther Res Clin Exp. 2009 Feb;70(1):10-8. doi: 10.1016/j.curtheres.2009.02.005.
Alzheimer's disease (AD) has the potential to become a major health concern and associated health care costs may become a significant economic burden on society.
The aim of this study was to estimate the direct medical costs attributable to AD in patients aged ≥60 years in Taiwan from 2000 through 2002 and to explore the correlation of these costs with patients' age and sex.
This study was based on the National Health Insurance Research Database of Taiwan's National Health Insurance (NHI) program. The NHI program insures >98% of the 23 million inhabitants of Taiwan. Detailed data were extracted from a random sample of 0.2% of inpatient and 5% of outpatient recipients with AD (International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code 331.0) who were aged ≥60 years and who received inpatient or outpatient services with claims from January 1, 2000, to December 31, 2002. Duplicate charges for a specific patient and diagnoses of other types of dementia were excluded from this study.
A total of 69,780 patients were found to have a diagnosis of AD. The direct medical costs for outpatients were estimated at US $1.2 million in 2000, US $1.9 million in 2001, and US $2.3 million in 2002; the costs for inpatient care were estimated at US $670,000 in 2000, US $2.4 million in 2001, and US $3.2 million in 2002. The total direct medical costs were estimated at US $1.86 million in 2000, US $4.24 million in 2001, and US $5.48 million in 2002. The increase of total direct medical costs was not significantly correlated with patients' age or sex.
From 2000 through 2002, the direct medical costs of AD increased annually in Taiwan among patients with AD aged ≥60 years. No significant correlation was found between increased total direct medical costs and sex or age. The cost estimate presented here has implications for future decision making about reallocating medical resources for treating AD in Taiwan.
阿尔茨海默病（AD）有可能成为主要的健康问题，相关的医疗保健费用可能会给社会带来巨大的经济负担。
本研究旨在估算2000年至2002年台湾60岁及以上AD患者的直接医疗费用，并探讨这些费用与患者年龄和性别的相关性。
本研究基于台湾全民健康保险（NHI）计划的全民健康保险研究数据库。NHI计划为台湾2300万居民中的98%以上提供保险。从年龄≥60岁、在2000年1月1日至2002年12月31日期间有住院或门诊报销记录的AD患者（国际疾病分类第九版临床修订本诊断代码331.0）中，随机抽取0.2%的住院患者样本和5%的门诊患者样本，提取详细数据。本研究排除了特定患者的重复收费以及其他类型痴呆症的诊断。
共发现69780例患者被诊断为AD。门诊患者的直接医疗费用在2000年估计为120万美元，2001年为190万美元，2002年为230万美元；住院护理费用在2000年估计为67万美元，2001年为240万美元，2002年为320万美元。2000年的总直接医疗费用估计为186万美元，2001年为424万美元，2002年为548万美元。总直接医疗费用的增加与患者的年龄或性别无显著相关性。
2000年至2002年期间，台湾60岁及以上AD患者的AD直接医疗费用逐年增加。总直接医疗费用的增加与性别或年龄之间未发现显著相关性。此处给出的费用估计对台湾未来重新分配治疗AD的医疗资源的决策具有启示意义。
