Aldeguer Xavier, Sicras-Mainar Antoni
Hospital Universitari Doctor Josep Trueta, Girona, Spain.
Badalona Serveis Assistencials, Badalona, Spain.
Gastroenterol Hepatol. 2016 Jan;39(1):9-19. doi: 10.1016/j.gastrohep.2015.04.007. Epub 2015 Jul 23.
To estimate the management of UC associated costs from the societal perspective in Spain.
Observational, longitudinal study with retrospective data collection based on reviews of outpatient health records. Socio-demographic, clinical and sick leave information was gathered. Patients diagnosed of UC between 2002 and 2012, older than 18 years, followed-up by a minimum of 12 months post diagnosis, with at least two clinical and use of resources data recorded, were included.
285 UC patients [51.2% men; 44.5 (SD: 15.6) years old; 88.4% without family history of UC; 39.3% proctitis; 5.6 (2.5) years disease follow-up] participated. More than half (65.6%) were active workers, 75.9% were on sick leave for reasons different from UC [mean 0.66 (0.70) times per year] during (mean) 28.43 (34.45) days. Only 64 patients were on UC-related sick-leaves, lasting (mean) 26.17 (37.43) days. Absenteeism due to medical visits caused loss of 29.55 (21.38) working hours per year. Mean direct and indirect annual cost per UC patient were €1754.10 (95%CI: 1473.37-2034.83) and €399.32 (282.31-422.69), respectively. Absenteeism was estimated at €88.21(32.72-50.06) per patient per year, in which sick-leaves were the main component of indirect costs (88.2%). Age, UC family history, diarrhea at diagnosis, blood and blood-forming organs diseases and psychological disorders were the main predictors of indirect costs.
UC is a costly disease for the society and the Spanish National Healthcare System. Indirect costs imply a major burden by affecting the most productive years of patients. Further research is needed considering all components of productivity loss, including presenteeism-associated costs.
从西班牙社会角度估算与溃疡性结肠炎（UC）相关的管理成本。
基于门诊健康记录回顾进行回顾性数据收集的观察性纵向研究。收集社会人口统计学、临床和病假信息。纳入2002年至2012年间诊断为UC、年龄超过18岁、诊断后至少随访12个月且至少记录两次临床和资源使用数据的患者。
285例UC患者参与研究[男性占51.2%；年龄44.5（标准差：15.6）岁；88.4%无UC家族史；39.3%为直肠炎；疾病随访时间为5.6（2.5）年]。超过一半（65.6%）为在职员工，75.9%因UC以外的原因休病假[平均每年0.66（0.70）次]，休假时间平均为28.43（34.45）天。只有64例患者因UC休病假，病假时间平均为26.17（37.43）天。因就医缺勤导致每年损失29.55（21.38）个工作小时。每位UC患者每年的直接和间接成本平均分别为1754.10欧元（95%置信区间：1473.37 - 2034.83）和399.32欧元（282.31 - 422.69）。估计每位患者每年的缺勤成本为88.21（32.72 - 50.06）欧元，其中病假是间接成本的主要组成部分（88.2%）。年龄、UC家族史、诊断时的腹泻、血液及造血器官疾病和心理障碍是间接成本的主要预测因素。
UC对社会和西班牙国家医疗保健系统来说是一种成本高昂的疾病。间接成本通过影响患者最具生产力的年份带来了重大负担。需要进一步研究考虑生产力损失的所有组成部分，包括与出勤主义相关的成本。
