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日本阿尔茨海默病痴呆的经济负担。

Economic Burden of Alzheimer's Disease Dementia in Japan.

机构信息

Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan.

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.

出版信息

J Alzheimers Dis. 2021;81(1):309-319. doi: 10.3233/JAD-210075.

Abstract

BACKGROUND

Alzheimer's disease dementia (ADD) is the leading cause of long-term care in Japan.

OBJECTIVE

This study estimates the annual healthcare and long-term care costs in fiscal year 2018 for adults over 65 years of age with ADD in Japan and the informal care costs and productivity loss for their families.

METHODS

Healthcare and long-term care costs for ADD were estimated according to the disease severity classified by the clinical dementia rating (CDR) score, using reports from a literature review. For the costs of time spent on caregiving activities, productivity loss for ADD family caregivers aged 20-69 and informal care costs for all ADD family caregivers were estimated.

RESULTS

The total healthcare cost of ADD was JPY 1,073 billion, of which 86% (JPY 923 billion) was attributed to healthcare costs other than ADD drug costs (JPY 151 billion). The healthcare costs other than ADD drug costs by severity were less than JPY 200 billion for CDR 0.5, CDR 1, and CDR 2, respectively, but increased to JPY 447 billion (48%) for CDR 3. The public long-term care costs were estimated to be JPY 4,783 billion, which increased according to the severity. Total productivity loss for ADD family caregivers aged 20-69 was JPY 1,547 billion and the informal care cost for all ADD family caregivers was JPY 6,772 billion.

CONCLUSION

ADD costs have a significant impact on public-funded healthcare, long-term care systems, and families in Japan. To minimize the economic burden of ADD, prolonging healthy life expectancy is the key factor to address.

摘要

背景

阿尔茨海默病痴呆症(ADD)是日本长期护理的主要原因。

目的

本研究估算了日本 2018 年 65 岁以上患有 ADD 的成年人的年度医疗保健和长期护理费用,以及他们的家庭的非正式护理费用和生产力损失。

方法

根据临床痴呆评定量表(CDR)评分所分类的疾病严重程度,使用文献综述报告来估算 ADD 的医疗保健和长期护理费用。对于护理活动所花费的时间成本,估算了年龄在 20-69 岁的 ADD 家庭照顾者的生产力损失和所有 ADD 家庭照顾者的非正式护理成本。

结果

ADD 的总医疗保健费用为 10730 亿日元,其中 86%(9230 亿日元)归因于 ADD 药物费用以外的医疗保健费用(1510 亿日元)。按严重程度分类,CDR 0.5、CDR 1 和 CDR 2 的 ADD 药物费用以外的医疗保健费用均低于 2000 亿日元,但 CDR 3 的医疗保健费用增加至 4470 亿日元(48%)。公共长期护理费用估计为 47830 亿日元,随着严重程度的增加而增加。年龄在 20-69 岁的 ADD 家庭照顾者的总生产力损失为 15470 亿日元,所有 ADD 家庭照顾者的非正式护理成本为 67720 亿日元。

结论

ADD 的费用对日本的公共资助医疗保健、长期护理系统和家庭产生了重大影响。为了最大程度地减少 ADD 的经济负担,延长健康预期寿命是解决问题的关键因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d9a/8203238/88f853c41cce/jad-81-jad210075-g001.jpg

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