The Swedish Institute for Health Economics, Lund, Sweden.
Department of Neurology, Rehabilitation Medicine, Memory Disorders, and Geriatrics, Skåne University Hospital, Malmö, Sweden.
Acta Neurol Scand. 2021 Nov;144(5):592-599. doi: 10.1111/ane.13502. Epub 2021 Jul 12.
To estimate resource use and costs, including direct and indirect costs, in relation to levels of severity in individuals with Parkinson's disease (PD) in a Swedish setting.
Patients with idiopathic PD registered in the National Parkinson's Disease Patient Registry (PARKreg), with registrations of Hoehn and Yahr (H&Y) and "off time" in the Skåne Region, were included. Annual costs of healthcare contacts, drugs, formal and informal care, and productivity loss associated with PD were estimated using data from PARKreg linked with regional and national healthcare registers between 2013 and 2019.
In total, 960 patients and 1324 observations (patient-years) were included. Total average cost per patient-year was SEK 168,982 (EUR 15,958) and ranged from SEK 62,404 (EUR 5893) for H&Y stage I to SEK 1,056,324 (EUR 99,755) in H&Y stage V. The dominating part of total costs for early stages were indirect costs accounting for 50-60% while formal care made up for 55% and 81% of total costs in H&Y IV and V, respectively. Total mean costs for formal care, informal care, and productivity loss also increased with increasing off-time.
Advanced and late stages of PD are associated with significant societal costs as patients in those stages often require resource-intensive and costly formal care. Thus, there are potential savings to be made, by optimizing the pharmacological and surgical symptomatic treatment of patients with advanced disease.
在瑞典环境中，估计与帕金森病（PD）个体严重程度相关的资源利用和成本，包括直接和间接成本。
纳入了在国家帕金森病患者登记处（PARKreg）登记的特发性 PD 患者，这些患者在斯科讷地区有 Hoehn 和 Yahr（H&Y）登记和“关闭时间”。使用 PARKreg 中的数据，结合 2013 年至 2019 年期间的区域和国家医疗保健登记处的数据，估计了与 PD 相关的医疗保健接触、药物、正式和非正式护理以及生产力损失的年度成本。
总共纳入了 960 名患者和 1324 次观察（患者年）。每位患者每年的平均总成本为 168982 瑞典克朗（15958 欧元），从 H&Y 1 期的 62404 瑞典克朗（5893 欧元）到 H&Y 5 期的 1056324 瑞典克朗（99755 欧元）不等。早期阶段总成本的主要部分是间接成本，占 50-60%，而在 H&Y 4 期和 5 期，正式护理分别占总成本的 55%和 81%。随着关闭时间的增加，正式护理、非正式护理和生产力损失的总成本也呈上升趋势。
PD 的晚期和晚期阶段与重大的社会成本相关，因为这些阶段的患者通常需要资源密集型和昂贵的正式护理。因此，通过优化晚期疾病患者的药物和手术症状治疗，可以节省潜在的费用。
