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慢性疼痛及其决定因素的社会成本:以奥地利为例。

The societal costs of chronic pain and its determinants: The case of Austria.

机构信息

Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria.

Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.

出版信息

PLoS One. 2019 Mar 20;14(3):e0213889. doi: 10.1371/journal.pone.0213889. eCollection 2019.

Abstract

BACKGROUND

Chronic pain is among the most burdensome conditions. Its prevalence ranges between 12% and 30% in Europe, with an estimated 21% among Austrian adults. The economic impact of chronic pain from a societal perspective, however, has not been sufficiently researched. This study aims to provide an estimate of the societal costs for working-age adults with chronic pain in Austria. It explores the impact of sex, number of pain sites, self-reported pain severity, health literacy and private health insurance on costs associated with chronic pain.

METHODS

A bottom-up cost-of-illness study was conducted based on data collected from 54 adult patients with chronic pain at three Viennese hospital outpatient departments. Information on healthcare costs including out-of-pocket expenses and productivity losses due to absenteeism and informal care were collected over 12 months. Resource use estimates were combined with unit costs and mean costs per patient were calculated in € for year 2016.

RESULTS

Mean annual societal costs were estimated at EUR 10191. Direct medical costs were EUR 5725 including EUR 1799 out-of-pocket expenses (mainly pain relieving activities and private therapy). Productivity losses including informal care amounted to EUR 4466. Total costs for women and patients with three or more pain sites were significantly higher. No association with health literacy was found but there was a tendency towards higher out-of-pocket expenses for patients with complementary private health insurance.

CONCLUSION

This study is the first to provide a comprehensive assessment of the individual and societal burden of chronic pain in Austria. It highlights that chronic pain is associated with substantial direct medical costs and productivity losses. Patient costs may show systematic differences by health insurance status, implying a need for future research in this area.

摘要

背景

慢性疼痛是最具负担的疾病之一。在欧洲,其患病率在 12%至 30%之间,奥地利成年人中有 21%估计患有慢性疼痛。然而,从社会角度来看,慢性疼痛的经济影响尚未得到充分研究。本研究旨在估计奥地利处于工作年龄的慢性疼痛患者的社会成本。它探讨了性别、疼痛部位数量、自我报告的疼痛严重程度、健康素养和私人医疗保险对与慢性疼痛相关的成本的影响。

方法

基于在维也纳三家医院门诊部门收集的 54 名慢性疼痛成年患者的数据,进行了一项自下而上的疾病成本研究。收集了 12 个月内与医疗保健相关的费用,包括自付费用和因缺勤和非正式护理导致的生产力损失。资源使用估计值与单位成本相结合,并计算出每位患者在 2016 年的欧元平均费用。

结果

估计每年的社会总成本为 10191 欧元。直接医疗费用为 5725 欧元,包括 1799 欧元的自付费用(主要是缓解疼痛的活动和私人治疗)。包括非正式护理在内的生产力损失总计为 4466 欧元。女性和有三个或更多疼痛部位的患者的总费用明显更高。与健康素养没有关联,但有互补私人医疗保险的患者自付费用有上升趋势。

结论

本研究首次全面评估了奥地利慢性疼痛对个人和社会的负担。它强调慢性疼痛与大量直接医疗费用和生产力损失有关。患者费用可能因健康保险状况而存在系统差异,这意味着未来需要在这一领域进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4268/6426226/4d12c51b3db1/pone.0213889.g001.jpg

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