Fløe Andreas, Hilberg Ole, Wejse Christian, Løkke Anders, Ibsen Rikke, Kjellberg Jakob, Jennum Poul
Department of Respiratory Medicine and Allergology, Aarhus University Hospital, Denmark.
Department of Respiratory Medicine and Allergology, Aarhus University Hospital, Denmark.
Int J Infect Dis. 2015 Mar;32:183-90. doi: 10.1016/j.ijid.2014.12.021.
To evaluate the economic burden of tuberculosis (TB) in Denmark,
8,433 Danish TB-patients (1998-2010) were matched with 33,707 controls by age, gender, civil status and geography. Health-related costs (health system contacts and -procedures, medications) and socio-economic parameters (foregone earnings and social transfer expenses) were calculated on data from national databases. The same information was obtained for 3,485 spouses of TB-patients, and 17,403 controls.
Health-related costs were higher for cases throughout the period. Before diagnosis, cases posed € 1,180 more health costs per year than controls. Excess health costs in the 2 years around diagnosing and treating TB were € 10,509. Cases received an average excess public transfer income of € 3,345 before vs. € 3,121 after diagnosis. Average employment income deficiency was € 11,635 before vs. € 13,885 after diagnosis, but the increasing difference showed a linear shape throughout the period. Spouses also had lower income, more social transfer, and posed higher health-related costs than matched controls.
We estimate the direct costs per TB patient to be €10,509. TB patients and their households are characterized by increasingly lower employment income, lower employment rate, and higher dependency on public transfer, but the socio/economic deterioration is rather a risk factor for TB than a direct consequence of the disease.
评估丹麦结核病（TB）的经济负担。
8433例丹麦结核病患者（1998 - 2010年）按照年龄、性别、婚姻状况和地理位置与33707例对照进行匹配。根据国家数据库中的数据计算与健康相关的费用（卫生系统接触和程序、药物治疗）以及社会经济参数（收入损失和社会转移支出）。对3485例结核病患者的配偶和17403例对照也获取了相同信息。
在此期间，病例的健康相关费用一直较高。在诊断前，病例每年的健康费用比对照多1180欧元。在结核病诊断和治疗前后两年，额外的健康费用为10509欧元。病例在诊断前平均额外获得公共转移收入3345欧元，诊断后为3121欧元。平均就业收入不足在诊断前为11635欧元，诊断后为13885欧元，但差异的增加在此期间呈线性。配偶的收入也较低，获得更多社会转移，且与匹配的对照相比，产生的健康相关费用更高。
我们估计每位结核病患者的直接费用为10509欧元。结核病患者及其家庭的特点是就业收入越来越低、就业率降低以及对公共转移的依赖性增加，但社会/经济恶化与其说是该疾病的直接后果，不如说是结核病的一个风险因素。
