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德国职业性皮肤病三级预防项目的经济评价。

Economic evaluation of a tertiary prevention program for occupational skin diseases in Germany.

机构信息

Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.

Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.

出版信息

Contact Dermatitis. 2020 Jun;82(6):361-369. doi: 10.1111/cod.13506. Epub 2020 Mar 25.

Abstract

BACKGROUND

Occupational skin diseases (OSDs) are the most common work-related diseases in Germany and responsible for a large individual and financial burden. Therefore, a tertiary individual prevention program (TIP) is offered to patients with severe OSD who are at increased risk of abandoning their profession.

OBJECTIVES

To define cost of illness (COI) of OSD in Germany and to economically evaluate the TIP from a societal perspective.

METHODS

In this study, data on patients taking part in the TIP (September 2005 to December 2009) were collected. Sociodemographic and medical data, costs, disease severity (Osnabrueck Hand Eczema Severity Index), and quality of life (QoL; Dermatology Life Quality Index) were assessed. COI and cost-effectiveness analyses were performed with a simulated control group.

RESULTS

In the analysis, 1041 patients were included. Intervention costs per person were €15 009 with decreasing COI over time. The incremental cost-effectiveness ratio revealed expenses per patient of €8942 for a reduction in severity level and €9093 for an improvement in QoL in the base case. Considering costs for retraining, the break-even point is reached if the TIP prevents retraining in approximately 64% of participants.

CONCLUSIONS

The decreased COI in this long-term evaluation indicates that the TIP is cost-effective in patients with severe OSD.

摘要

背景

职业性皮肤病(OSD)是德国最常见的与工作相关的疾病,给个人和社会带来了巨大的负担。因此,为患有严重 OSD 且有较高职业放弃风险的患者提供三级个体预防计划(TIP)。

目的

明确德国 OSD 的疾病经济负担(COI),并从社会角度对 TIP 进行经济性评估。

方法

本研究收集了参加 TIP(2005 年 9 月至 2009 年 12 月)的患者的数据。评估了人口统计学和医疗数据、成本、疾病严重程度(奥斯纳布吕克手部湿疹严重程度指数)和生活质量(QoL;皮肤病生活质量指数)。使用模拟对照组进行了 COI 和成本效益分析。

结果

分析纳入了 1041 名患者。每人的干预成本为 15009 欧元,随着时间的推移 COI 逐渐降低。增量成本效益比显示,严重程度每降低一级,每位患者的费用为 8942 欧元,QoL 每提高一级,费用为 9093 欧元。考虑到再培训成本,TIP 可以预防大约 64%的参与者进行再培训,此时可以达到收支平衡。

结论

在长期评估中,COI 的降低表明 TIP 在严重 OSD 患者中具有成本效益。

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