Matsumoto Kunichika, Hanaoka Simpei, Wu Yinghui, Hasegawa Tomonori
Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan.
Chiba Psychiatric Medical Center, Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan.
J Stroke Cerebrovasc Dis. 2017 Sep;26(9):1934-1940. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.022. Epub 2017 Jul 13.
The purpose of this study was to calculate the burden of 3 major diseases (cancer, heart disease, and cerebrovascular disease [CVD]) using the cost of illness (COI) method.
As a modification of the original COI method developed by Rice, the estimated comprehensive COI (C-COI) of cancer, heart disease, and CVD were redefined. C-COI consists of medical direct, morbidity, and mortality costs (MtCs; components of the original COI); long-term care (LTC) direct cost (DC); and family burden (FB). LTC DC is an insurance benefit, and FB is the unpaid care cost incurred by the family, relatives, and friends for in-home and in-community medical expenses (opportunity cost). All costs for 2008-2014 were calculated using official statistics of the Japanese government.
The C-COI of cancer, heart disease, and CVD in 2014 amounted to 9815 billion Japanese yen (JPY), 4461 billion JPY, and 6501 billion JPY, respectively. As for the composition of the C-COI, the MtC accounted for the largest portion of medical expenses for treatment of cancer (63.5%) and heart disease (50.6%), but the DC (LTC) accounted for the largest portion of medical expenses for CVD (26.7%).
This study, based on government statistics, demonstrated that C-COI, including LTC DC and FB, could be estimated, and the latter was found to be a major cost component in CVD, whereas long-term disability is a salient feature of the disease.
本研究旨在运用疾病成本(COI)法计算三种主要疾病(癌症、心脏病和脑血管疾病[CVD])的负担。
作为对Rice开发的原始COI方法的改进,重新定义了癌症、心脏病和CVD的估计综合COI(C-COI)。C-COI包括医疗直接成本、发病率和死亡率成本(MtC;原始COI的组成部分);长期护理(LTC)直接成本(DC);以及家庭负担(FB)。LTC DC是一种保险福利,FB是家庭、亲属和朋友为家庭和社区内医疗费用产生的未支付护理成本(机会成本)。2008 - 2014年的所有成本均使用日本政府的官方统计数据计算得出。
2014年癌症、心脏病和CVD的C-COI分别达到98150亿日元、44610亿日元和65010亿日元。至于C-COI的构成,MtC在癌症(63.5%)和心脏病(50.6%)治疗的医疗费用中占最大比例,但DC(LTC)在CVD医疗费用中占最大比例(26.7%)。
本研究基于政府统计数据表明,可以估计包括LTC DC和FB在内的C-COI,并且发现后者是CVD的主要成本组成部分,而长期残疾是该疾病的一个显著特征。