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非传染性疾病和精神健康状况的经济负担:哥斯达黎加、牙买加和秘鲁的结果

The economic burden of noncommunicable diseases and mental health conditions: results for Costa Rica, Jamaica, and Peru.

作者信息

Bloom David E, Chen Simiao, McGovern Mark E

机构信息

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.

CHaRMS - Centre for Health Research at Queen's Management School, Queen's University Belfast, Belfast, Antrim, Northern Ireland.

出版信息

Rev Panam Salud Publica. 2018 Feb 28;42:e18. doi: 10.26633/RPSP.2018.18. eCollection 2018.

Abstract

OBJECTIVE

We extend the EPIC model of the World Health Organization (WHO) and apply it to analyze the macroeconomic impact of noncommunicable diseases (NCDs) and mental health conditions in Costa Rica, Jamaica, and Peru.

METHODS

The EPIC model quantifies the impact of NCDs and mental health conditions on aggregate output solely through the effect of chronic conditions on labor supply due to mortality. In contrast, the expanded EPIC-H Plus framework also incorporates reductions in effective labor supply due to morbidity and negative effects of health expenditure on output via the diversion of productive savings and reduced capital accumulation. We apply this methodology to Costa Rica, Jamaica, and Peru and estimate gross domestic product (GDP) output lost due to four leading NCDs (cardiovascular disease, cancer, chronic respiratory disease, and diabetes) and mental health conditions in these countries from 2015 to 2030. We also estimate losses from all NCDs and mental health conditions combined.

RESULTS

Overall, our results show total losses associated with all NCDs and mental health conditions over the period 2015-2030 of US$ 81.96 billion (2015 US$) for Costa Rica, US$ 18.45 billion for Jamaica, and US$ 477.33 billion for Peru. Moderate variation exists in the magnitude of the burdens of diseases for the three countries. In Costa Rica and Peru, respiratory disease and mental health conditions are two leading contributors to lost output, while in Jamaica, cardiovascular disease alone accounts for 20.8% of the total loss, followed by cancer.

CONCLUSIONS

These results indicate that the economic impact of NCDs and mental health conditions is substantial and that interventions to reduce the prevalence of chronic conditions in countries of Latin America and the Caribbean are likely to be highly cost-beneficial.

摘要

目的

我们扩展了世界卫生组织(WHO)的EPIC模型,并将其应用于分析哥斯达黎加、牙买加和秘鲁非传染性疾病(NCDs)及精神健康状况的宏观经济影响。

方法

EPIC模型仅通过慢性病导致的死亡率对劳动力供应的影响来量化非传染性疾病和精神健康状况对总产出的影响。相比之下,扩展后的EPIC-H Plus框架还纳入了因病态导致的有效劳动力供应减少,以及健康支出通过生产性储蓄转移和资本积累减少对产出产生的负面影响。我们将此方法应用于哥斯达黎加、牙买加和秘鲁,并估计了2015年至2030年期间这三个国家因四种主要非传染性疾病(心血管疾病、癌症、慢性呼吸道疾病和糖尿病)及精神健康状况而损失的国内生产总值(GDP)产出。我们还估计了所有非传染性疾病和精神健康状况综合造成的损失。

结果

总体而言,我们的结果显示,2015年至2030年期间,哥斯达黎加与所有非传染性疾病和精神健康状况相关的总损失为819.6亿美元(2015年美元),牙买加为184.5亿美元,秘鲁为4773.3亿美元。这三个国家疾病负担的严重程度存在适度差异。在哥斯达黎加和秘鲁,呼吸道疾病和精神健康状况是产出损失的两个主要原因,而在牙买加,仅心血管疾病就占总损失的20.8%,其次是癌症。

结论

这些结果表明,非传染性疾病和精神健康状况的经济影响巨大,在拉丁美洲和加勒比地区国家采取干预措施降低慢性病患病率可能具有很高的成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71ab/6386108/50858f5d0f1b/rpsp-42-e18-g001.jpg

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