Frey S
Hamburg Center for Health Economics (HCHE), University of Hamburg, Hamburg, Esplanade 36, 20354 Hamburg, Germany.
Eur Psychiatry. 2014 Oct;29(8):479-89. doi: 10.1016/j.eurpsy.2014.04.003. Epub 2014 May 19.
Prior studies to determine the economic consequences of schizophrenia have largely been undertaken in clinical settings with a small number of cases and have been unable to analyze effects across different age cohorts. The aim of this study is to investigate the burden of schizophrenia in Germany.
Costs, service utilization, and premature mortality attributable to schizophrenia were estimated for the year 2008 using a retrospective matched cohort design. Therefore, 26,977 control subjects as well as 9411 individuals with a confirmed diagnosis of schizophrenia were drawn from a sickness fund claims database. To reduce conditional bias, the non-parametric genetic matching method was employed.
The final study population comprised 8224 matched pairs. The annual cost attributable to schizophrenia was €11,304 per patient from the payers' perspective and €20,609 from the societal perspective with substantial variations among age groups: direct medical expenses were highest among patients aged>65 years, whereas younger individuals (<25 years) incurred the greatest non-medical costs. The annual burden of schizophrenia from the perspective of German society ranges between €9.63 billion and €13.52 billion.
There are considerable differences in the distribution of costs and service utilization for schizophrenia. Because schizophrenia is characterized by an early age of onset and a long duration, research efforts should be targeted at particular populations to obtain the most beneficial outcomes, both clinically and economically.
先前确定精神分裂症经济后果的研究大多在临床环境中进行，病例数量较少，且无法分析不同年龄队列的影响。本研究的目的是调查德国精神分裂症的负担。
采用回顾性匹配队列设计，估计2008年精神分裂症所致的成本、服务利用情况和过早死亡率。因此，从一个疾病基金索赔数据库中抽取了26977名对照受试者以及9411名确诊为精神分裂症的个体。为减少条件偏差，采用了非参数遗传匹配方法。
最终研究人群包括8224对匹配个体。从支付方角度来看，精神分裂症患者每年的成本为每人11304欧元，从社会角度来看为20609欧元，各年龄组之间存在显著差异：65岁以上患者的直接医疗费用最高，而25岁以下的年轻人产生的非医疗成本最高。从德国社会角度来看，精神分裂症的年度负担在96.3亿欧元至135.2亿欧元之间。
精神分裂症在成本分布和服务利用方面存在相当大的差异。由于精神分裂症具有发病早和病程长的特点，研究工作应针对特定人群，以在临床和经济方面获得最有益的结果。
