Research Centre for Public Health, Tsinghua University, Beijing, China .
Centre for Health Economic Experiments and Public Policy, Shandong University, Jinan, China .
Bull World Health Organ. 2017 Jan 1;95(1):18-26. doi: 10.2471/BLT.15.167726. Epub 2016 Oct 18.
To quantify and predict the economic burden of dementia in China for the periods 1990-2010 and 2020-2030, respectively, and discuss the potential implications for national public health policy.
Using a societal, prevalence-based, gross cost-of-illness approach and data from multiple sources, we estimated or predicted total annual economic costs of dementia in China. We included direct medical costs in outpatient and inpatient settings, direct non-medical costs - e.g. the costs of transportation - and indirect costs due to loss of productivity. We excluded comorbidity-related costs.
The estimated total annual costs of dementia in China increased from 0.9 billion United States dollars (US$) in 1990 to US$ 47.2 billion in 2010 and were predicted to reach US$ 69.0 billion in 2020 and US$ 114.2 billion in 2030. The costs of informal care accounted for 94.4%, 92.9% and 81.3% of the total estimated costs in 1990, 2000 and 2010, respectively. In China, population ageing and the increasing prevalence of dementia were the main drivers for the increasing predicted costs of dementia between 2010 and 2020, and population ageing was the major factor contributing to the growth of dementia costs between 2020 and 2030.
In China, demographic and epidemiological transitions have driven the growth observed in the economic costs of dementia since the 1990s. If the future costs of dementia are to be reduced, China needs a nationwide dementia action plan to develop an integrated health and social care system and to promote primary and secondary prevention.
分别量化和预测中国在 1990-2010 年和 2020-2030 年期间痴呆症的经济负担,并讨论其对国家公共卫生政策的潜在影响。
采用基于患病率的全人群疾病经济负担研究方法,结合多源数据,估算或预测中国痴呆症的年度经济总负担。我们纳入了门诊和住院治疗的直接医疗费用、交通等直接非医疗费用以及因生产力损失导致的间接费用,但排除了与合并症相关的费用。
中国痴呆症的年度总经济负担从 1990 年的 9.9 亿美元增加到 2010 年的 472 亿美元,预计到 2020 年将达到 690 亿美元,到 2030 年将达到 1142 亿美元。在估算的总费用中,非正式照料费用分别占 1990 年、2000 年和 2010 年的 94.4%、92.9%和 81.3%。在中国,人口老龄化和痴呆症患病率的增加是导致 2010 年至 2020 年期间痴呆症预测费用增加的主要原因,而人口老龄化是导致 2020 年至 2030 年期间痴呆症费用增长的主要因素。
自 20 世纪 90 年代以来,人口结构和流行病学变化推动了中国痴呆症经济负担的增长。如果要降低未来痴呆症的成本,中国需要制定一项全国性的痴呆症行动计划,以建立一个综合的卫生和社会保健系统,并促进初级和二级预防。