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关节炎导致丧失生产性生命年的长期经济影响:来自澳大利亚微观模拟模型的结果。

The long-term economic impacts of arthritis through lost productive life years: results from an Australian microsimulation model.

机构信息

GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Department of Economics, Faculty of Business and Economics, Macquarie University, Sydney, NSW, 2107, Australia.

The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.

出版信息

BMC Public Health. 2018 May 24;18(1):654. doi: 10.1186/s12889-018-5509-3.

Abstract

BACKGROUND

While the direct (medical) costs of arthritis are regularly reported in cost of illness studies, the 'true' cost to indivdiuals and goverment requires the calculation of the indirect costs as well including lost productivity due to ill-health.

METHODS

Respondents aged 45-64 in the ABS Survey of Disability, Ageing and Carers 2003, 2009 formed the base population. We projected the indirect costs of arthritis using Health&WealthMOD2030 - Australia's first microsimulation model on the long-term impacts of ill-health in older workers - which incorporated outputs from established microsimulation models (STINMOD and APPSIM), population and labour force projections from Treasury, and chronic conditions trends for Australia. All costs of arthritis were expressed in real 2013 Australian dollars, adjusted for inflation over time.

RESULTS

We estimated there are 54,000 people aged 45-64 with lost PLYs due to arthritis in 2015, increasing to 61,000 in 2030 (13% increase). In 2015, people with lost PLYs are estimated to receive AU$706.12 less in total income and AU$311.67 more in welfare payments per week than full-time workers without arthritis, and pay no income tax on average. National costs include an estimated loss of AU$1.5 billion in annual income in 2015, increasing to AU$2.4 billion in 2030 (59% increase). Lost annual taxation revenue was projected to increase from AU$0.4 billion in 2015 to $0.5 billion in 2030 (56% increase). We projected a loss in GDP of AU$6.2 billion in 2015, increasing to AU$8.2 billion in 2030.

CONCLUSIONS

Significant costs of arthritis through lost PLYs are incurred by individuals and government. The effectiveness of arthritis interventions should be judged not only on healthcare use but quality of life and economic wellbeing.

摘要

背景

虽然疾病负担研究经常报告关节炎的直接(医疗)成本,但个人和政府的“真实”成本还需要计算间接成本,包括因健康不佳而导致的生产力损失。

方法

2003 年和 2009 年,澳大利亚统计局残疾、老龄化和照顾者调查中的 45-64 岁受访者构成了基础人群。我们使用 Health&WealthMOD2030 来预测关节炎的间接成本,这是澳大利亚第一个针对老年工人健康不佳的长期影响的微观模拟模型,该模型纳入了来自成熟的微观模拟模型(STINMOD 和 APPSIM)、财政部的人口和劳动力预测以及澳大利亚慢性病趋势的输出。所有关节炎成本均以 2013 年的实际澳元表示,随时间推移进行了通货膨胀调整。

结果

我们估计 2015 年有 54000 名 45-64 岁的人因关节炎而失去了 PLYs,到 2030 年将增加到 61000 人(增加 13%)。2015 年,与没有关节炎的全职工人相比,失去 PLYs 的人每周的总收入预计会减少 706.12 澳元,福利支出会增加 311.67 澳元,而且平均无需缴纳所得税。全国成本包括 2015 年估计损失 15 亿澳元的年收入,到 2030 年将增加到 24 亿澳元(增加 59%)。预计 2015 年的未缴年度税款将从 4 亿澳元增加到 2030 年的 5 亿澳元(增加 56%)。我们预测 2015 年 GDP 将损失 62 亿澳元,到 2030 年将损失 82 亿澳元。

结论

个人和政府因失去 PLYs 而承担了关节炎的重大成本。关节炎干预措施的效果不仅应根据医疗保健的使用情况来判断,还应根据生活质量和经济福利来判断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5657/5968603/0fe125fae83e/12889_2018_5509_Fig1_HTML.jpg

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