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呼吁制定统一的阿尔茨海默病成本收集策略:综述和荟萃分析。

Call for a Uniform Strategy of Collecting Alzheimer's Disease Costs: A Review and Meta-Analysis.

机构信息

Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic.

出版信息

J Alzheimers Dis. 2018;63(1):227-238. doi: 10.3233/JAD-171028.

Abstract

BACKGROUND

There is now a general attempt in developed countries to implement strategic plans to fight against Alzheimer's disease and other dementia disorders. Among others, attention is paid to the issues of registers and calculations of economic burden. Currently available calculations of costs are difficult to compare. The problem is a different breakdown of cost categories and non-unified monitoring of cost types.

OBJECTIVE

The aim of this paper is to note the problem of poor availability and inconsistencies in cost monitoring. Furthermore, the intersection of cost items that are comparable and consistently monitored in expert studies are specified.

METHODS

The Web of Science, Elsevier Science Direct, PubMed, and Scopus databases are used in a systematic review. Two independent reviewers screened the identified records and selected relevant articles published in the period from 2010 to 2016. A meta-analysis of costs is performed in four categories related to patients suffering from Alzheimer's disease.

RESULTS

The resulting estimation of total costs per patient per month through meta-analysis is € 3,896, with 95% CI [2078, 5713]. The highest costs arise from informal care following non-medical and medical care.

CONCLUSION

The results confirm assumption that inconsistencies in cost monitoring of the treatment and care of people with dementia exists in Europe. Homogeneity could be assumed only in the medical costs of severe patients. Heterogeneity is assumed in non-medical costs, informal costs. Cost items should be defined and collected more precisely for future more precise monitoring of the economic burden.

摘要

背景

目前,发达国家普遍试图实施战略计划来对抗阿尔茨海默病和其他痴呆症。其中,人们关注登记册和经济负担计算等问题。目前的成本计算难以比较。问题在于成本类别的细分不同,以及成本类型的监测未统一。

目的

本文旨在指出成本监测可用性差和不一致的问题。此外,还确定了专家研究中可比较且一致监测的成本项目的交点。

方法

本系统评价使用了 Web of Science、Elsevier Science Direct、PubMed 和 Scopus 数据库。两名独立审查员筛选了确定的记录,并选择了 2010 年至 2016 年期间发表的相关文章。对与阿尔茨海默病患者相关的四个类别进行了成本荟萃分析。

结果

荟萃分析得出的每位患者每月总费用的估计值为 3896 欧元,95%CI [2078, 5713]。非正式护理的成本最高,其次是非医疗和医疗护理。

结论

结果证实了这样一种假设,即欧洲对痴呆症患者治疗和护理的成本监测存在不一致性。只有在重症患者的医疗费用方面可以假设同质性。在非医疗成本和非正式成本方面则假设异质性。应该更准确地定义和收集成本项目,以便未来更准确地监测经济负担。

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