Norwich Medical School, University of East Anglia, Norfolk, United Kingdom.
The Ipswich Hospital, Ipswich, United Kingdom.
Rhinology. 2020 Apr 1;58(2):112-125. doi: 10.4193/Rhin19.424.
Chronic rhinosinusitis (CRS) is highly prevalent, affecting 11% of the population. Studies evaluating the socio-economic impact of CRS are mostly limited to the US population. Currently there is no study that has evaluated the socio-economic costs of CRS in the UK.
A case-control study of patients with CRS and healthy controls was conducted to investigate the wider socio-economic impact of the disease. Data on demographic and socioeconomic characteristics, out-of-pocket expenditure (OOPE), health resource utilisation, productivity losses and health-related quality of life (HRQoL) via the EQ-5D and SNOT-22 instruments, were collected from questionnaires.
A total of 139 CRS participants and 67 control participants completed the questionnaires. The average total OOPE per patient extrapolated to a 12-month period was £304.84. Other important findings include significantly higher reported primary care interactions (4.14 vs. 1.16) as well as secondary care interactions (2.61 vs 0.4) in CRS group as compared to controls over three-months. The average total missed workdays was estimated to be 18.7 per patient per year. The estimated incremental healthcare cost of CRS per year is £16.8 billion or £2.8 billion per million inhabitants. Factors predictive of a higher OOPE include higher household occupancy and income and these accounted for only 9.7% of the total variance in total OOPEs. Other socioeconomic, demographic and HRQoL variables were not found to be predictive factors of OOPE.
This study showed that CRS has a significant wider economic burden beyond the immediate direct healthcare costs. CRS participants had a high level of healthcare service use, OOPE and productivity loss. Results from this study will add to the existing limited data both for the UK and abroad and emphasises the need for effective treatments for these patients to reduce the disease impact.
慢性鼻-鼻窦炎（CRS）的发病率很高，影响了 11%的人群。评估 CRS 社会经济影响的研究大多仅限于美国人群。目前，尚无研究评估 CRS 在英国的社会经济成本。
对 CRS 患者和健康对照者进行了病例对照研究，以调查该疾病更广泛的社会经济影响。通过 EQ-5D 和 SNOT-22 量表从问卷调查中收集了人口统计学和社会经济学特征、自付费用（OOPE）、卫生资源利用、生产力损失和健康相关生活质量（HRQoL）的数据。
共 139 名 CRS 患者和 67 名对照者完成了问卷。每个患者在 12 个月内的平均总 OOPE 为 304.84 英镑。其他重要发现包括与对照组相比，CRS 组在三个月内报告的初级保健互动（4.14 次与 1.16 次）以及二级保健互动（2.61 次与 0.4 次）显著更高。估计每位患者每年平均缺勤天数为 18.7 天。估计 CRS 每年的增量医疗保健成本为 168 亿英镑，或每百万居民 28 亿英镑。可预测 OOPE 较高的因素包括更高的家庭人口和收入，这些因素仅占 OOPE 总方差的 9.7%。其他社会经济、人口统计学和 HRQoL 变量未被发现是 OOPE 的预测因素。
这项研究表明，CRS 除了直接医疗保健成本之外，还具有重大的更广泛的经济负担。CRS 患者的医疗服务利用率、自付费用和生产力损失较高。这项研究的结果将增加国内外现有有限数据的内容，并强调需要为这些患者提供有效的治疗方法，以减轻疾病的影响。
