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评估阿尔茨海默病经济负担的主要成本驱动因素:一项结构化、快速审查。

Major Cost Drivers in Assessing the Economic Burden of Alzheimer's Disease: A Structured, Rapid Review.

机构信息

Mark Connolly PhD, Unit of Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands,

出版信息

J Prev Alzheimers Dis. 2021;8(3):362-370. doi: 10.14283/jpad.2021.17.

Abstract

BACKGROUND

Alzheimer's Disease is the most common cause of dementia, affecting memory, thinking and behavior. Symptoms eventually grow severe enough to interfere with daily tasks. AD is predicted to increase healthcare spending and costs associated with formal and informal caregiving. The aim of this study was to identify and quantify the contribution of the different cost components associated with AD.

METHODS

A structured literature review was conducted to identify studies reporting the economic burden of Alzheimer`s Disease beyond the healthcare setting. The search was conducted in Medline, Embase and EconLit and limited to studies published in the last 10 years. For each identified cost component, frequency weighted mean costs were calculated across countries to estimate the percentage contribution of each component by care setting and disease severity. Results obtained by each costing approach were also compared.

RESULTS

For community-dwelling adults, the percentage of healthcare, social care and indirect costs to total costs were 13.9%, 17.4% and 68.7%, respectively. The percentage of costs varied by disease severity with 26.0% and 10.4% of costs spent on healthcare for mild and severe disease, respectively. The proportion of total spending on indirect costs changed from 60.7% to 72.5% as disease progressed. For those in residential care, the contribution of each cost component was similar between moderate and severe disease. Social care accounted on average for 85.9% of total costs.

CONCLUSION

The contribution of healthcare costs to the overall burden was not negligible; but was generally exceeded by social and informal care costs.

摘要

背景

阿尔茨海默病是痴呆症最常见的病因,影响记忆、思维和行为。症状最终严重到足以干扰日常任务。预计阿尔茨海默病将增加医疗保健支出以及与正式和非正式护理相关的成本。本研究的目的是确定和量化与阿尔茨海默病相关的不同成本构成部分的贡献。

方法

进行了系统的文献综述,以确定报告超出医疗保健环境的阿尔茨海默病经济负担的研究。在 Medline、Embase 和 EconLit 中进行了搜索,并将搜索范围限制在过去 10 年发表的研究。对于每个确定的成本构成部分,在各国计算了频率加权平均成本,以估计每个构成部分在不同护理环境和疾病严重程度下的贡献百分比。还比较了每种成本估算方法的结果。

结果

对于居住在社区的成年人,医疗保健、社会护理和间接成本占总费用的比例分别为 13.9%、17.4%和 68.7%。疾病严重程度不同,医疗保健成本的比例也不同,轻度和重度疾病的医疗保健成本分别占 26.0%和 10.4%。随着疾病的进展,间接成本占总支出的比例从 60.7%变为 72.5%。对于居住在养老院的人,中度和重度疾病的每种成本构成部分的贡献相似。社会护理平均占总费用的 85.9%。

结论

医疗保健成本对总负担的贡献不可忽视;但通常被社会和非正式护理成本所超过。

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