College of Pharmacy, Ewha Womans University, Seoul 03760, Korea.
Korean Health Insurance Review & Assessment Service, Wonju 26465, Korea.
Int J Environ Res Public Health. 2022 Feb 22;19(5):2494. doi: 10.3390/ijerph19052494.
We sought to estimate the lifetime healthcare costs and outcomes associated with the exposure to the escalated concentration of fine particulate matter (particle size < 2.5 μm, PM2.5) among adult Korean women. We adapted a previously developed Markov model, and a hypothetical cohort composed of Korean women was exposed to either a standard (15 μg/m3) or increased (25 μg/m3) concentration of PM2.5. The time horizon of the analysis was 60 years, and the cycle length was 1 year. The outcomes were presented as direct healthcare costs and quality-adjusted life years (QALYs), and costs were discounted annually at 5%. Deterministic and probabilistic sensitivity analyses were performed. The model estimated that when the exposure concentration was increased by 10 μg/m3, the lifetime healthcare cost increased by USD 9309, which is an 11.3% increase compared to the standard concentration group. Women exposed to a higher concentration of PM2.5 were predicted to live 30.64 QALYs, compared to 32.08 QALYs for women who were exposed to the standard concentration of PM2.5. The tendency of a higher cost and shorter QALYs at increased exposure was consistent across a broad range of sensitivity analyses. The negative impact of PM2.5 was higher on cost than on QALYs and accelerated as the exposure time increased, emphasizing the importance of early intervention.
我们旨在估计成年韩国女性接触细颗粒物（粒径<2.5μm，PM2.5）浓度升高所带来的终身医疗保健成本和结果。我们采用了先前开发的马尔可夫模型，将一个假设的韩国女性队列暴露于标准（15μg/m3）或增加（25μg/m3）浓度的 PM2.5 中。分析的时间范围为 60 年，周期长度为 1 年。结果以直接医疗保健成本和质量调整生命年（QALY）表示，成本每年按 5%贴现。进行了确定性和概率敏感性分析。该模型估计，当暴露浓度增加 10μg/m3 时，终身医疗保健成本增加 9309 美元，与标准浓度组相比增加了 11.3%。与暴露于标准 PM2.5 浓度的女性相比，暴露于更高浓度 PM2.5 的女性预计寿命为 30.64 个 QALY。在广泛的敏感性分析中，暴露增加导致更高的成本和更短的 QALYs 的趋势是一致的。PM2.5 的负面影响在成本上高于 QALY ，并且随着暴露时间的增加而加速，这强调了早期干预的重要性。
