de Oliveira Claire, Macdonald Erin M, Green Diane, Colton Patricia, Olmsted Marion, Bondy Susan, Kurdyak Paul
Centre for Addiction and Mental Health (de Oliveira, Kurdyak); Institute for Health Policy, Management and Evaluation (de Oliveira, Kurdyak), University of Toronto; Institute for Clinical Evaluative Sciences (de Oliveira, Macdonald, Green, Bondy, Kurdyak); Toronto General Hospital (Colton, Olmsted), University Health Network; Department of Psychiatry (Colton, Olmsted, Kurdyak), University of Toronto; Dalla Lana School of Public Health (Bondy), University of Toronto, Toronto, Ont.
CMAJ Open. 2016 Nov 3;4(4):E661-E667. doi: 10.9778/cmajo.20160057. eCollection 2016 Oct-Dec.
Eating disorders, specifically anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified, represent a substantial burden to the health care system. Our goal was to estimate the economic burden of patients who received specialized inpatient care for an eating disorder out of country.
We conducted a cost-of-illness study evaluating health care costs among patients in Ontario who received specialized inpatient care for an eating disorder out of country from 2003 to 2011, from the public third-party payer perspective. Using linked administrative databases, we estimated net costs of eating disorders for 2 patient groups: those who received specialized inpatient care both out of country and in province ( = 160), and those who received specialized inpatient care out of country only ( = 126).
Patients approved for specialized out-of-country inpatient care were mostly girls and young women from high-income, urban neighbourhoods. Total net costs varied annually and were higher for patients treated both out of country and in province (about $11 million before 2007, $6.5 million after) than for those treated out of country alone (about $5 million and $2 million, respectively). The main cost drivers were out-of-country care and physician services.
Costs associated with eating disorder care represent a substantial economic burden to the Ontario health care system. Given the high costs of out-of-country care, there may be opportunity to redirect these funds to increase capacity and expertise for eating disorder treatment within Ontario.
饮食失调，特别是神经性厌食症、神经性贪食症和未另行规定的饮食失调症，给医疗保健系统带来了沉重负担。我们的目标是估计在国外接受饮食失调专科住院治疗的患者的经济负担。
我们进行了一项疾病成本研究，从公共第三方支付者的角度评估2003年至2011年在安大略省接受国外饮食失调专科住院治疗的患者的医疗保健成本。利用关联的行政数据库，我们估计了两组患者饮食失调的净成本：那些在国外和省内都接受专科住院治疗的患者（n = 160），以及那些仅在国外接受专科住院治疗的患者（n = 126）。
获批在国外接受专科住院治疗的患者大多是来自高收入城市社区的女孩和年轻女性。总净成本每年有所不同，在国外和省内都接受治疗的患者（2007年之前约1100万美元，之后约650万美元）比仅在国外接受治疗的患者（分别约为500万美元和200万美元）更高。主要成本驱动因素是国外医疗服务和医生服务。
与饮食失调治疗相关的成本给安大略省医疗保健系统带来了巨大的经济负担。鉴于国外医疗服务成本高昂，可能有机会重新分配这些资金，以提高安大略省内饮食失调治疗的能力和专业水平。
