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[德国痴呆症疾病的经济和社会负担——一项荟萃分析]

[The economic and social burden of dementia diseases in Germany-A meta-analysis].

作者信息

Michalowsky Bernhard, Kaczynski Anika, Hoffmann Wolfgang

机构信息

AG Translationale Versorgungsforschung, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Standort Rostock/Greifswald, Ellernholzstraße 1-2, 17489, Greifswald, Deutschland.

Abteilung Versorgungsepidemiologie und Community Health, Institute for Community Medicine, Universitätsmedizin Greifswald, Greifswald, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019 Aug;62(8):981-992. doi: 10.1007/s00103-019-02985-z.

Abstract

BACKGROUND

Currently, there are 1.7 million people living with dementia (PwD) in Germany. This number is expected to double within the next decades. Estimates of the total societal economic burden of dementia are currently missing.

OBJECTIVES

The aim was to estimate the current and future total cost and excess cost of dementia from a public payer and societal perspective.

METHODS

Studies demonstrating the healthcare resource utilization of PwD in Germany were identified. Utilization data were aggregated using the sample size of different studies as a weight. Annual per capita costs of PwD and excess cost of dementia were calculated using standardized unit costs. Current and future costs were calculated based on published prevalence and population forecasts.

RESULTS

PwD living at home had lower costs from a payer perspective compared to those who are institutionalized, but higher total societal cost due to the higher informal care time. The total cost for PwD from a payer perspective was 34 billion € in 2016. These costs could reach 90 billion € by 2060. The excess cost of dementia was 18 billion € in 2016 and is estimated to become 49 billion € by 2060 from a payer perspective, representing 54% of the total cost of PwD and up to 15% of the total costs associated with the elderly population. The total societal cost was 73 billion € in 2016 and is estimated to become 194 billion € by 2060. The excess cost of dementia was 54 billion € in 2016 and is estimated to become 145 billion € by 2060, representing 74% of the total societal cost of PwD and 36% of the total societal cost of the elderly.

CONCLUSION

Dementia diseases represent a tremendous social and economic burden. Without a cure, supporting caregivers and implementing interventions that delay the functional and cognitive decline will be crucial to relieving the increasing costs.

摘要

背景

目前,德国有170万人患有痴呆症。预计在未来几十年内,这一数字将翻倍。目前尚缺乏对痴呆症社会经济总负担的估计。

目的

旨在从公共支付方和社会角度估计痴呆症当前和未来的总成本及额外成本。

方法

检索了表明德国痴呆症患者医疗资源利用情况的研究。利用不同研究的样本量作为权重对利用数据进行汇总。使用标准化单位成本计算痴呆症患者的人均年度成本和痴呆症的额外成本。根据已公布的患病率和人口预测计算当前和未来成本。

结果

从支付方角度来看,居家生活的痴呆症患者成本低于机构化患者,但由于非正式护理时间更长,其社会总成本更高。2016年,从支付方角度来看,痴呆症患者的总成本为340亿欧元。到2060年,这些成本可能达到900亿欧元。从支付方角度来看,2016年痴呆症的额外成本为180亿欧元,预计到2060年将增至490亿欧元,占痴呆症患者总成本的54%,占老年人口总成本高达15%。2016年社会总成本为730亿欧元,预计到2060年将增至1940亿欧元。2016年痴呆症的额外成本为540亿欧元,预计到2060年将增至1450亿欧元,占痴呆症患者社会总成本的74%,占老年人社会总成本的36%。

结论

痴呆症疾病构成了巨大的社会和经济负担。在无法治愈的情况下,支持护理人员并实施延缓功能和认知衰退的干预措施对于缓解不断增加的成本至关重要。

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