Pezzullo Lynne, Streatfeild Jared, Simkiss Philippa, Shickle Darren
Deloitte Access Economics Pty Ltd, 8 Brindabella Circuit, Canberra Airport, 2609, ACT, Australia.
Royal National Institute of Blind People, London, UK.
BMC Health Serv Res. 2018 Jan 30;18(1):63. doi: 10.1186/s12913-018-2836-0.
To quantify the economic impact of sight loss and blindness in the United Kingdom (UK) population, including direct and indirect costs, and its burden on health.
Prevalence data on sight loss and blindness by condition, Census demographic data, data on indirect costs, and healthcare cost databases were used. Blindness was defined as best corrected visual acuity (BCVA) of < 6/60, and sight loss as BCVA < 6/12 to 6/60, in the better-seeing eye.
Sight loss and blindness from age-related macular degeneration (AMD), cataract, diabetic retinopathy, glaucoma and under-corrected refractive error are estimated to affect 1.93 (1.58 to 2.31) million people in the UK. Direct health care system costs were £3.0 billion, with inpatient and day care costs comprising £735 million (24.6%) and outpatient costs comprising £771 million (25.8%). Indirect costs amounted to £5.65 (5.12 to 6.22) billion. The value of the loss of healthy life associated with sight loss and blindness was estimated to be £19.5 (15.9 to 23.3) billion or £7.2 (5.9 to 8.6) billion, depending on the set of disability weights used. For comparison with other published results using 2004 disability weights and the 2008 estimates, the total economic cost of sight loss and blindness was estimated to be £28.1 (24.0 to 32.5) billion in 2013. Using 2010 disability weights, the estimated economic cost of sight loss and blindness was estimated to be £15.8 (13.5 to 18.3) billion in 2013.
The large prevalence of sight loss and blindness in the UK population imposes significant costs on public funds, private expenditure, and health. Prevalence estimates relied on dated epidemiological studies and may not capture recent advances in treatment, highlighting the need for population-based studies that track the prevalence of sight-impairing eye conditions and treatment effects over time.
为了量化英国人口中视力丧失和失明的经济影响,包括直接和间接成本,以及其对健康的负担。
使用了按病情分类的视力丧失和失明患病率数据、人口普查人口统计数据、间接成本数据以及医疗保健成本数据库。失明定义为较好眼的最佳矫正视力(BCVA)<6/60,视力丧失定义为BCVA<6/12至6/60。
据估计,年龄相关性黄斑变性(AMD)、白内障、糖尿病视网膜病变、青光眼和屈光不正矫正不足导致的视力丧失和失明影响了英国193万(158万至231万)人。直接医疗系统成本为30亿英镑,其中住院和日间护理成本为7.35亿英镑(24.6%),门诊成本为7.71亿英镑(25.8%)。间接成本达56.5亿(51.2亿至62.2亿)英镑。根据所使用的残疾权重集,与视力丧失和失明相关的健康生命损失价值估计为195亿(159亿至233亿)英镑或72亿(59亿至86亿)英镑。为了与其他使用2004年残疾权重和2008年估计值发表的结果进行比较,2013年视力丧失和失明的总经济成本估计为281亿(240亿至325亿)英镑。使用2010年残疾权重,2013年视力丧失和失明的估计经济成本估计为158亿(135亿至183亿)英镑。
英国人口中视力丧失和失明的高患病率给公共资金、私人支出和健康带来了巨大成本。患病率估计依赖于过时的流行病学研究,可能无法反映近期的治疗进展,这凸显了开展基于人群的研究以跟踪视力损害眼病患病率和治疗效果随时间变化情况的必要性。