Yao Wang, Le Qihua
Department of Ophthalmology, Eye & ENT Hospital of Fudan University, No.83 Fenyang Road, Shanghai, 200031, China.
BMC Ophthalmol. 2018 Feb 2;18(1):23. doi: 10.1186/s12886-018-0694-5.
Sjogren's syndrome is the leading cause for aqueous tear-deficiency dry eye. Little is known regarding the relationship between Sjogren's syndrome dry eye (SSDE) and patients' medical expenditure, clinical severity and psychological status changes.
Thirty-four SSDE patients and thirty non-Sjogren's syndrome dry eye (non-SSDE) subjects were enrolled. They were required to complete three self-report questionnaires: Ocular Surface Disease Index, Zung Self Rating Anxiety Scales, and a questionnaire designed by the researchers to study the patients' treatment, medical expenditure and income. The correlations between expenditures and these parameters were analyzed.
The annual total expenditure on the treatment of SSDE was Chinese Yuan 7637.2 (approximately US$1173.8) on average, and the expense paid by SSDE patients themselves was Chinese Yuan 2627.8 (approximately US$403.9), which were 5.5 and 4.5 times higher than non-SSDE patients (both P < 0.001). The annual total expense on Chinese medicine and western medicine were 35.6 times and 78.4% higher in SSDE group than in non-SSDE group (both P < 0.001). Moreover, indirect costs associated with the treatment were 70.0% higher in SSDE group. In SSDE group, the score of Zung Self Rating Anxiety Scales had significantly positive correlation with total medical expenditure and the expense on Chinese medicine (ρ = 0.399 and ρ = 0.400,both P = 0.019). Nevertheless, total medical expenditure paid by the patients in non-SSDE group positively correlated with the score of Ocular Surface Disease Index (ρ = 0.386, P = 0.035).
Medication expenditures and associated costs is an unignorable economic burden to the patients with SSDE. The medical expense had a significantly correlation with clinical severity of SSDE and the patients' psychological status.
干燥综合征是泪液分泌不足型干眼症的主要病因。关于干燥综合征干眼症（SSDE）与患者医疗支出、临床严重程度及心理状态变化之间的关系，人们了解甚少。
招募了34例SSDE患者和30例非干燥综合征干眼症（非SSDE）受试者。要求他们完成三份自我报告问卷：眼表疾病指数、zung自评焦虑量表，以及研究人员设计的一份关于患者治疗、医疗支出和收入的问卷。分析了支出与这些参数之间的相关性。
SSDE治疗的年总支出平均为7637.2元人民币（约合1173.8美元），SSDE患者自付费用为2627.8元人民币（约合403.9美元），分别是非SSDE患者的5.5倍和4.5倍（均P < 0.001）。SSDE组中药和西药的年总费用分别比非SSDE组高35.6倍和78.4%（均P < 0.001）。此外，SSDE组治疗相关的间接费用高70.0%。在SSDE组中，zung自评焦虑量表得分与总医疗支出和中药费用呈显著正相关（ρ = 0.399和ρ = 0.400，均P = 0.019）。然而，非SSDE组患者的总医疗支出与眼表疾病指数得分呈正相关（ρ = 0.386，P = 0.035）。
药物支出及相关费用对SSDE患者来说是一个不可忽视的经济负担。医疗费用与SSDE的临床严重程度及患者心理状态显著相关。
