Pham Luyen Dinh, Vo Trung Quang, Nguyen Hoan Bich, Pham An Thanh, Dang Nga ThiKieu, Chung Phan Thuy Tran
Department of Pharmacy Administration, Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
Department of Economic and Administrative Pharmacy, Pham Ngoc Thach University of Medicine,Vietnam .
J Pak Med Assoc. 2019 Jun;69(Suppl 2)(6):S10-S19.
Chronic rhinosinusitis (CRS) is a popular and tiring disease with significant impacts on the economy and on the Health-related Quality of Life (HRQOL) of patients. This study aims to estimate the cost of illness (COI) and to assess the Health-related Quality of Life (HRQOL) in patients with CRS who underwent surgery in Vietnam and to analyse the relationship between socio-demographic characteristics and the COI as well as the HRQOL.
A cross-sectional study was conducted in Ear, Nose, Throat Hospital in Ho Chi Minh City (ENT Hospital HCMC), Vietnam between August and October 2018. The direct medical and non-medical costs, the indirect costs (productivity loss), and the HRQOL of patients with CRS were measured. A subjective assessment of quality of life (QOL) using EuroQol 5 Dimensions 5 Levels (EQ-5D-5L) was used to evaluate the health status of these patients after surgery. Characteristics related with the COI and the HRQOL were identified by multiple regression.
A total of 264 inpatients with CRS participated in the study. The mean COI for inpatients with CRS was $812.83 and direct costs accounted for a major proportion (89.32%) of the total cost. In addition, the surgery represented the most significant direct medical cost with 58.57% of the total cost. Most of the patients reported no problems with mobility (89.1%), self-care (93.9%), usual activities (77.2%), and anxiety/depression (64.0%). The mean EQ-5D-5L utility score was 0.76 (SD = 0.17), and the mean Visual Analogue Scale (EQ-VAS) score was 76.57 (SD = 13.34). The results of multiple regression showed that gender, occupations, monthly income, prior surgery and family history of CRS affected the total cost while the HRQOL of patients were related to education, smoking behaviour, exercise behaviour and family history of CRS.
This study showed that although endoscopic sinus surgery (ESS) accounted for the largest expense in the COI, this surgical treatment helped to improve the HRQOL in patients with CRS. The findings provided a reference for policy makers in CRS management as well as for adjustment of costs for patients so as to reduce disease burden and to enhance their QOL.
慢性鼻-鼻窦炎（CRS）是一种常见且令人疲惫的疾病，对经济和患者的健康相关生活质量（HRQOL）有重大影响。本研究旨在估算越南接受手术治疗的CRS患者的疾病成本（COI），评估其健康相关生活质量（HRQOL），并分析社会人口学特征与COI以及HRQOL之间的关系。
2018年8月至10月在越南胡志明市耳鼻喉医院（胡志明市耳鼻喉医院）进行了一项横断面研究。测量了CRS患者的直接医疗和非医疗成本、间接成本（生产力损失）以及HRQOL。使用欧洲五维健康量表（EQ-5D-5L）对生活质量（QOL）进行主观评估，以评估这些患者术后的健康状况。通过多元回归确定与COI和HRQOL相关的特征。
共有264例CRS住院患者参与了该研究。CRS住院患者的平均COI为812.83美元，直接成本占总成本的主要部分（89.32%）。此外，手术是最主要的直接医疗成本，占总成本的58.57%。大多数患者在行动能力（89.1%）、自我护理（93.9%）、日常活动（77.2%）和焦虑/抑郁（64.0%）方面没有问题。EQ-5D-5L效用评分的平均值为0.76（标准差=0.17），视觉模拟量表（EQ-VAS）评分的平均值为76.57（标准差=13.34）。多元回归结果显示，性别、职业、月收入、既往手术史和CRS家族史影响总成本，而患者的HRQOL与教育程度、吸烟行为、运动行为和CRS家族史有关。
本研究表明，尽管鼻内镜鼻窦手术（ESS）在COI中占最大支出，但这种手术治疗有助于改善CRS患者的HRQOL。研究结果为CRS管理的政策制定者以及患者费用调整提供了参考，以减轻疾病负担并提高其生活质量。
