Huang L F, Cartwright W S, Hu T W
Department of Economics, Howard University, Washington, DC 20059.
Public Health Rep. 1988 Jan-Feb;103(1):3-7.
Senile dementia is a progressive and irreversible decline of mental functions. The symptoms are mental confusion, memory loss, disorientation, cognitive decline, and inappropriate social behavior. It is one of the most common, costly, and distressful diseases among the elderly in the United States. Information on the economic costs of senile dementia is essential for determining research priorities and the allocation of resources to support aging and medical research. Economic consequences, such as direct medical and nonmedical expenditures by patients' families and the amount of time by third parties in caring for patients with senile dementia, are substantial. However, little systematic accounting to estimate these consequences has been undertaken. This paper attempts to estimate various costs associated with the care of senile dementia, based on available secondary data. We have used the direct cost and indirect cost approach and avoided double counting to identify the additional economic costs due to senile dementia. The total, direct national cost of senile dementia is $13.26 billion, which includes $6.36 billion of medical care costs, $2.56 billion of nursing home care costs, and $4.34 billion of social agency service costs. The indirect cost for community home care alone is $31.46 billion, more than twice the total direct costs. The costs of premature death and loss of productivity due to senile dementia are about $43.17 billion. Although most of the indirect costs were imputed from the value of housekeeping or productivity loss, the magnitude of indirect costs reflects the serious consequences and burden on society's resources of this disease.
老年痴呆症是一种精神功能的进行性和不可逆衰退。症状包括精神错乱、记忆力丧失、定向障碍、认知能力下降以及不适当的社会行为。它是美国老年人中最常见、代价最高且最令人痛苦的疾病之一。有关老年痴呆症经济成本的信息对于确定研究重点以及分配资源以支持衰老和医学研究至关重要。经济后果相当严重,例如患者家庭的直接医疗和非医疗支出以及第三方照顾老年痴呆症患者所花费的时间。然而,很少有人进行系统的核算来估计这些后果。本文试图根据现有的二手数据来估计与老年痴呆症护理相关的各种成本。我们采用了直接成本和间接成本方法,并避免重复计算以确定因老年痴呆症产生的额外经济成本。老年痴呆症的全国直接总成本为132.6亿美元,其中包括63.6亿美元的医疗护理成本、25.6亿美元的疗养院护理成本以及43.4亿美元的社会机构服务成本。仅社区家庭护理的间接成本就达314.6亿美元,是直接总成本的两倍多。因老年痴呆症导致的过早死亡和生产力损失成本约为431.7亿美元。尽管大部分间接成本是根据家务劳动价值或生产力损失估算的,但间接成本的规模反映了这种疾病对社会资源造成的严重后果和负担。