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在西班牙,社区居住的阿尔茨海默病患者的成本和生活质量:来自 GERAS II 观察性研究的结果。

Costs and quality of life in community-dwelling patients with Alzheimer's disease in Spain: results from the GERAS II observational study.

机构信息

Hospital General Universitario Gregorio Marañón,Madrid,Spain.

Hospital Universitario 12 de Octubre and CIBERSAM,Madrid,Spain.

出版信息

Int Psychogeriatr. 2017 Dec;29(12):2081-2093. doi: 10.1017/S1041610217001211. Epub 2017 Jul 19.

Abstract

BACKGROUND

Country-specific data on resource use and costs associated with Alzheimer's disease (AD) help inform governments about the increasing need for medical and financial support as the disease increases in prevalence.

METHODS

GERAS II, a prospective observational study, assessed resource use, costs, and health-related quality of life (HRQoL) among patients with AD and their caregivers in Spain. Community-dwelling patients aged ≥55 years with probable AD, and their primary caregivers, were recruited by study investigators during routine clinical practice and assessed as having mild, moderate, or moderately severe/severe (MS/S) AD dementia based on patient Mini-Mental State Examination scores. Costs of AD were calculated by applying costs to resource-use data obtained in caregiver interviews using the Resource Utilization in Dementia instrument. Total societal costs included patients' health and social care costs and caregiver informal care costs. Baseline results are presented.

RESULTS

Total mean monthly societal costs/patient (2013 values) were €1514 for mild (n = 116), €2082 for moderate (n = 118), and €2818 for MS/S AD dementia (n = 146) (p value <0.001 between groups). Caregiver informal care costs comprised most of the total societal costs and differed significantly between groups (€1050, €1239, €1580, respectively; p value = 0.013), whereas patient healthcare costs did not. Across AD dementia severity groups, patient HRQoL (measured by proxy) decreased significantly (p value <0.001), caregiver subjective burden significantly increased (p value <0.001) and caregiver HRQoL was similar.

CONCLUSIONS

Societal costs associated with AD in Spain were largely attributable to caregiver informal care costs and increased with increasing AD dementia severity.

摘要

背景

与阿尔茨海默病(AD)相关的资源利用和成本的特定国家数据有助于告知政府,随着疾病的流行率增加,对医疗和财政支持的需求不断增加。

方法

GERAS II 是一项前瞻性观察性研究,评估了西班牙 AD 患者及其护理人员的资源利用、成本和与健康相关的生活质量(HRQoL)。研究人员在常规临床实践中招募了年龄≥55 岁、患有可能的 AD 的社区居住患者及其主要护理人员,并根据患者的简易精神状态检查评分评估他们患有轻度、中度或中度/重度(MS/S)AD 痴呆。使用资源利用在痴呆症工具(Resource Utilization in Dementia instrument),通过将资源使用数据应用于护理人员访谈中获得的数据,计算 AD 的成本。总社会成本包括患者的医疗和社会护理成本以及护理人员的非正式护理成本。呈现基线结果。

结果

轻度 AD(n = 116)、中度 AD(n = 118)和 MS/S AD 痴呆(n = 146)患者每月总社会成本/患者(2013 年)分别为 1514 欧元(p 值<0.001)。护理人员的非正式护理成本构成了总社会成本的大部分,且各组之间差异显著(分别为 1050 欧元、1239 欧元、1580 欧元;p 值 = 0.013),而患者的医疗保健成本没有差异。在 AD 痴呆严重程度组中,患者的 HRQoL(通过代理测量)显著下降(p 值<0.001),护理人员的主观负担显著增加(p 值<0.001),而护理人员的 HRQoL 相似。

结论

西班牙与 AD 相关的社会成本主要归因于护理人员的非正式护理成本,且随着 AD 痴呆严重程度的增加而增加。

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