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基于医疗保健和长期护理服务利用的痴呆症社会经济成本:一项回顾性队列研究。

Socioeconomic Costs of Dementia Based on Utilization of Health Care and Long-Term-Care Services: A Retrospective Cohort Study.

机构信息

Health Insurance Research Institute, National Health Insurance Service, Wonju Gangwon-do 26464, Korea.

Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul 03722, Korea.

出版信息

Int J Environ Res Public Health. 2021 Jan 6;18(2):376. doi: 10.3390/ijerph18020376.

Abstract

This study examined the socioeconomic costs of dementia based on the utilization of healthcare and long-term care services in South Korea. Using 2016 data from two national insurance databases and a survey study, persons with dementia were categorized into six groups based on healthcare and long-term care services used: long-term care insurance users with home- and community-based services (n = 93,346), nursing home services (n = 69,895), and combined services (n = 16,068); and long-term care insurance non-users cared for by family at home (n = 192,713), living alone (n = 19,526), and admitted to long-term-care hospitals (n = 65,976). Their direct and indirect costs were estimated. The total socioeconomic cost of dementia was an estimated US$10.9 billion for 457,524 participants in 2016 (US$23,877 per person). Among the six groups, the annual per-person socioeconomic cost of dementia was lowest for long-term care insurance users who received home- and community-based services (US$21,391). It was highest for long-term care insurance non-users admitted to long-term care hospitals (US$26,978). Effective strategies are necessary to promote long-term care insurance with home- and community-based services to enable persons with dementia to remain in their communities as long as possible while receiving cost-efficient, quality care.

摘要

本研究基于韩国医疗保健和长期护理服务的利用情况,考察了痴呆症的社会经济成本。使用来自两个国家保险数据库和一项调查研究的 2016 年数据,根据使用的医疗保健和长期护理服务,将痴呆症患者分为六组:使用长期护理保险享受居家和社区服务的人(n = 93,346)、使用养老院服务的人(n = 69,895)和同时使用两种服务的人(n = 16,068);以及未使用长期护理保险、由家人在家中照顾的人(n = 192,713)、独居的人(n = 19,526)和入住长期护理医院的人(n = 65,976)。他们的直接和间接成本被估算出来。2016 年,457,524 名参与者的痴呆症总社会经济成本估计为 109 亿美元(人均 23,877 美元)。在这六组中,接受居家和社区服务的长期护理保险使用者的痴呆症人均年社会经济成本最低(21,391 美元)。而入住长期护理医院的未使用长期护理保险者的成本最高(26,978 美元)。需要采取有效的策略来推广居家和社区为基础的长期护理保险,以使痴呆症患者能够尽可能长时间地留在社区中,同时获得具有成本效益的优质护理。

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