Michaud Tzeyu L, High Robin, Charlton Mary E, Murman Daniel L
*Center for Reducing Health Disparities †Department of Health Promotion, Social and Behavioral Health, College of Public Health ‡Department of Biostatistics ∥Behavioral and Geriatric Neurology Program, Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE §Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA.
Alzheimer Dis Assoc Disord. 2017 Jul-Sep;31(3):209-217. doi: 10.1097/WAD.0000000000000198.
The level of assistance patients with Alzheimer disease (AD) require in their care may be an important predictor of resource use, costs of care, and quality of life. The Dependence Scale (DS), a measure of care-assistance required, was used to estimate costs of care and quality of life of patients with AD categorized into 6 dependence stages based upon the summated item scores of the DS. Data were derived from a 3-year, noninterventional study of 132 patients with probable AD (ages, 50 to 85 y) and caregiver dyads. We investigated the association between DS scores and health care costs, health-related quality of life (HRQoL), caregiver burden and estimated annual costs and HRQoL for 6 dependence stages in adjusted models. DS scores were significant predictors of health care costs, HRQoL, and caregiver burden. The estimated annual health care costs and a measure of HRQoL (EuroQoL-5D) ranged from $11,418 and 1.00 for those at very mild dependence stage to $101,715 and 0.26 for those at very severe dependence stage. DS scores classified into 6 dependence stages provides a useful method to estimate unique levels of care-associated costs and health utilities for pharmacoeconomic evaluations of new treatments for AD.
阿尔茨海默病(AD)患者在护理中所需的协助程度可能是资源使用、护理成本和生活质量的重要预测指标。依赖量表(DS)是一种衡量所需护理协助的工具,用于根据DS的总项目得分将AD患者分为6个依赖阶段,从而估算护理成本和生活质量。数据来自一项对132例可能患有AD的患者(年龄50至85岁)及其照顾者二元组进行的为期3年的非干预性研究。我们在调整模型中研究了DS得分与医疗保健成本、健康相关生活质量(HRQoL)、照顾者负担之间的关联,以及6个依赖阶段的估计年度成本和HRQoL。DS得分是医疗保健成本、HRQoL和照顾者负担的重要预测指标。估计的年度医疗保健成本和HRQoL指标(欧洲五维健康量表)从非常轻度依赖阶段的11,418美元和1.00到非常重度依赖阶段的101,715美元和0.26不等。分为6个依赖阶段的DS得分提供了一种有用的方法,可用于估算AD新治疗药物经济学评估中与护理相关的独特成本水平和健康效用。