Barbosa J P, Ferreira-Magalhães M, Sá-Sousa A, Azevedo L F, Fonseca J A
MEDCIDS: Department of Community Medicine, Information and Decision in Health (MEDCIDS), Faculdade de Medicina, Universidade do Porto, Portugal.
MEDCIDS: Department of Community Medicine, Information and Decision in Health (MEDCIDS), Faculdade de Medicina, Universidade do Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Centro de Investigação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Department of Pediatrics, Centro Hospitalar de São João, Porto, Portugal.
Rev Port Pneumol (2006). 2017 Nov-Dec;23(6):323-330. doi: 10.1016/j.rppnen.2017.07.003. Epub 2017 Aug 12.
Asthma is one of the most frequent chronic diseases, putting a considerable economic burden on societies and individuals. We aimed to estimate the total cost of adult asthma in Portugal, as well as the extent to which direct and indirect costs are influenced by the level of asthma control.
A nationwide, prevalence-based, cost-of-illness study using a bottom-up approach to calculate direct and indirect costs of asthma was conducted, using participant data from the Portuguese National Asthma Survey (INAsma). Direct (healthcare service usage, diagnostic tests and treatment) and indirect (absenteeism and transportation) costs were measured. Decision analytic modelling was used to perform multivariate deterministic sensitivity analysis.
On average, each adult costs 708.16€ (95%CI: 594.62-839.30) a year, with direct costs representing 93% (658.46€; 95%CI: 548.99-791.29) and indirect costs representing 7% (49.70€; 95%CI: 32.08-71.56). This amounts to a grand total of 386,197,211.25€ (95%CI: 324,279,674.31-457,716,500.18), with direct costs being 359,093,559.82€ (95%CI: 299,391,930.03-431,533,081.07). Asthma direct costs are 2.04% of the total Portuguese healthcare expense in 2010. The major cost domains were acute care usage (30.7%) and treatment (37.4%). Asthma control was significantly associated with higher costs throughout several domains, most notably in acute medical care.
Asthma in adults poses a significant economic burden on the Portuguese healthcare system, accounting for over 2% of the total healthcare expenditure in Portugal in 2010. It is important to note that a considerable portion of this burden might be eased by improving asthma control in patients, as uncontrolled patients' costs are more than double those of controlled asthma patients.
哮喘是最常见的慢性疾病之一，给社会和个人带来了相当大的经济负担。我们旨在估算葡萄牙成年哮喘患者的总成本，以及哮喘控制水平对直接和间接成本的影响程度。
采用自下而上的方法，利用葡萄牙全国哮喘调查（INAsma）的参与者数据，开展了一项基于患病率的全国性疾病成本研究，以计算哮喘的直接和间接成本。测量了直接成本（医疗服务使用、诊断测试和治疗）和间接成本（旷工和交通费用）。使用决策分析模型进行多变量确定性敏感性分析。
平均而言，每位成年患者每年花费708.16欧元（95%置信区间：594.62 - 839.30），其中直接成本占93%（658.46欧元；95%置信区间：548.99 - 791.29），间接成本占7%（49.70欧元；95%置信区间：32.08 - 71.56）。这总计达386,197,211.25欧元（95%置信区间：324,279,674.31 - 457,716,500.18），其中直接成本为359,093,559.82欧元（95%置信区间：299,391,930.03 - 431,533,081.07）。2010年，哮喘直接成本占葡萄牙医疗总费用的2.04%。主要成本领域为急性护理使用（30.7%）和治疗（37.4%）。在多个领域，哮喘控制与更高的成本显著相关，最明显的是在急性医疗护理方面。
成年哮喘给葡萄牙医疗系统带来了巨大的经济负担，占2010年葡萄牙医疗总支出的2%以上。需要注意的是，通过改善患者的哮喘控制，这一负担的很大一部分可能会减轻。因为未得到控制的患者的成本是哮喘得到控制的患者的两倍多。
