在严重财务限制下计算成本：希腊一家三级医院脊柱关节炎的疾病成本分析
Counting Costs under Severe Financial Constraints: A Cost-of-Illness Analysis of Spondyloarthropathies in a Tertiary Hospital in Greece.
作者信息
Tsifetaki Niki, Migkos Michail P, Papagoras Charalampos, Voulgari Paraskevi V, Athanasakis Kostas, Drosos Alexandros A
机构信息
From the Department of Rheumatology, General Hospital "G. Hatzikosta"; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina; Laboratory of Molecular Hematology, Medical School, Democritus University of Thrace, Alexandroupolis; Department of Health Economics, National School of Public Health, Athens, Greece.N. Tsifetaki, MD, Consultant Rheumatologist, Department of Rheumatology, General Hospital "G. Hatzikosta"; M.P. Migkos, MD, Fellow in Rheumatology, Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; C. Papagoras, MD, PhD, Rheumatologist, Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, and Laboratory of Molecular Hematology, Medical School, Democritus University of Thrace; P.V. Voulgari, MD, Associate Professor of Rheumatology, Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; K. Athanasakis, PhD, Research Fellow, Department of Health Economics, National School of Public Health; A.A. Drosos, MD, FACR, Professor of Medicine/Rheumatology, Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina.
出版信息
J Rheumatol. 2015 Jun;42(6):963-7. doi: 10.3899/jrheum.141277. Epub 2015 Apr 1.
OBJECTIVE
To investigate the total annual direct cost of patients with spondyloarthritis (SpA) in Greece.
METHODS
Retrospective study with 156 patients diagnosed and followed up in the rheumatology clinic of the University Hospital of Ioannina. Sixty-four had ankylosing spondylitis (AS) and 92 had psoriatic arthritis (PsA). Health resource use for each patient was elicited through a retrospective chart review that documented the use of monitoring visits, medications, laboratory/diagnostic tests, and inpatient stays for the previous year from the date that the review took place. Costs were calculated from a third-party payer perspective and are reported in 2014 euros.
RESULTS
The mean ± SD annual direct cost for the patients with SpA reached €8680 ± 6627. For the patients with PsA and AS, the cost was estimated to be €8097 ± 6802 and €9531 ± 6322, respectively. The major cost was medication, which represented 88.9%, 88.2%, and 89.3% of the mean total direct cost for SpA, AS, and PsA, respectively. The annual amount of the scheduled tests for all patients corresponded to 7.5%, and for those performed on an emergency basis, 1.1%. Further, the cost for scheduled and emergency hospitalization, as well as the cost of scheduled visits to an outpatient clinic, corresponded to 2.5% of the mean total annual direct cost for the patients with SpA.
CONCLUSION
SpA carries substantial financial cost, especially in the era of new treatment options. Adequate access and treatment for patients with SpA remains a necessity, even in times of fiscal constraint. Thus, the recommendations of the international scientific organizations should be considered when administering high-cost drugs such as biological treatments.
目的
调查希腊脊柱关节炎（SpA）患者的年度直接总成本。
方法
对约阿尼纳大学医院风湿病诊所诊断并随访的156例患者进行回顾性研究。其中64例为强直性脊柱炎（AS）患者，92例为银屑病关节炎（PsA）患者。通过回顾性病历审查获取每位患者的卫生资源使用情况，该审查记录了自审查之日起前一年的监测就诊、药物、实验室/诊断检查及住院情况。成本从第三方支付方的角度进行计算，并以2014年欧元报告。
结果
SpA患者的年平均直接成本为8680 ± 6627欧元。PsA和AS患者的成本估计分别为8097 ± 6802欧元和9531 ± 6322欧元。主要成本是药物，分别占SpA、AS和PsA平均总直接成本的88.9%、88.2%和89.3%。所有患者的定期检查年度费用占7.5%，急诊检查占1.1%。此外，定期和急诊住院费用以及门诊定期就诊费用占SpA患者年平均总直接成本的2.5%。
结论
SpA带来巨大的经济成本，尤其是在有新治疗选择的时代。即使在财政紧张时期，为SpA患者提供充分的治疗途径和治疗仍然是必要的。因此，在使用生物治疗等高成本药物时，应考虑国际科学组织的建议。
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