Department of Geriatric Medicine, University of Duisburg-Essen, Germaniastrasse 1-3, 45356, Essen, Germany.
Department of Neurology, Philipps-University Marburg, Marburg, Germany.
Pharmacoeconomics. 2021 May;39(5):601-615. doi: 10.1007/s40273-021-01011-y. Epub 2021 Mar 19.
The Care of Late-Stage Parkinsonism (CLaSP) study aimed to collect qualitative and standardized patient data in six European countries (France, Germany, Netherlands, Portugal, UK, Sweden) to enable a detailed evaluation of the underexplored late stages of the disease (Hoehn and Yahr stage > 3) using clinical, neuropsychological, behavioral, and health economic data. The aim of this substudy was to provide a health economic evaluation for the German healthcare system.
In Germany, 228 patients were included in the study. Costs were calculated from a societal perspective for a 3-month period. Univariate analyses were performed to identify cost-driving predictors. Total and direct costs were analyzed using a generalized linear model with a γ-distributed dependent variable and log link function. Indirect costs were analyzed using a binomial generalized linear model with probit link function.
The mean costs for the 3-month period were approximately €20,000. Informal care costs and hospitalization are approximately €11,000 and €5000. Direct costs amounted to 89% of the total costs, and the share of indirect costs was 11%. Independent predictors of total costs were the duration of the disease and age. The duration of the disease was the main independent predictor of direct costs, whereas age was an independent predictor of indirect costs.
Costs in the late stage of the disease are considerably higher than those found in earlier stages. Compared to the latter, the mean number of days in hospital and the need for care is increasing. Informal caregivers provide most of the care.
The protocol was registered at ClinicalTrials.gov as NCT02333175 on 7 January, 2015.
晚期帕金森病护理（CLaSP）研究旨在收集六个欧洲国家（法国、德国、荷兰、葡萄牙、英国和瑞典）的定性和标准化患者数据，以便使用临床、神经心理学、行为和健康经济学数据详细评估疾病的未充分探索的晚期阶段（Hoehn 和 Yahr 分期>3）。本研究子目的是为德国卫生保健系统提供健康经济学评估。
在德国，共有 228 例患者纳入该研究。从社会角度计算了 3 个月期间的成本。进行单变量分析以确定成本驱动因素。使用具有γ分布的因变量和对数链接函数的广义线性模型分析总费用和直接费用。使用具有概率单位链接函数的二项式广义线性模型分析间接费用。
3 个月期间的平均费用约为 20000 欧元。非正规护理费用和住院费用约为 11000 欧元和 5000 欧元。直接费用占总费用的 89%，间接费用的份额为 11%。总费用的独立预测因素是疾病持续时间和年龄。疾病持续时间是直接费用的主要独立预测因素，而年龄是间接费用的独立预测因素。
疾病晚期的成本明显高于早期阶段。与后者相比，住院天数和护理需求的平均值增加。非正规护理人员提供大部分护理。
该方案于 2015 年 1 月 7 日在 ClinicalTrials.gov 上注册为 NCT02333175。
