Davis Lori L, Schein Jeff, Cloutier Martin, Gagnon-Sanschagrin Patrick, Maitland Jessica, Urganus Annette, Guerin Annie, Lefebvre Patrick, Houle Christy R
Research Service, Tuscaloosa Veterans Affairs Medical Center, Tuscaloosa, Alabama.
Department of Psychiatry, University of Alabama School of Medicine, Birmingham, Alabama.
J Clin Psychiatry. 2022 Apr 25;83(3):21m14116. doi: 10.4088/JCP.21m14116.
To estimate the economic burden of posttraumatic stress disorder (PTSD) in the United States civilian and military populations from a societal perspective. A prevalence-based and human capital approach was used to estimate the total excess costs of PTSD in 2018 from insurance claims data, academic literature, and governmental publications. Excess direct health care costs (pharmacy, medical), direct non-health care costs (research and training, substance use, psychotherapy, homelessness, disability), and indirect costs (unemployment, productivity loss, caregiving, premature mortality) associated with PTSD were compared between adults with PTSD and adults without PTSD, or the general population if information was not available for adults without PTSD. The total excess economic burden of PTSD in the US was estimated at $232.2 billion for 2018 ($19,630 per individual with PTSD). Total excess costs were $189.5 billion (81.6%) in the civilian population and $42.7 billion (18.4%) in the military population, corresponding to $18,640 and $25,684 per individual with PTSD in the civilian and military populations, respectively. In the civilian population, the excess burden was driven by direct health care ($66.0 billion) and unemployment ($42.7 billion) costs. In the military population, the excess burden was driven by disability ($17.8 billion) and direct health care ($10.1 billion) costs. The economic burden of PTSD goes beyond direct health care costs and has been found to rival costs for other costly mental health conditions. Increased awareness of PTSD, development of more effective therapies, and expansion of evidence-based interventions may be warranted to reduce the large clinical and economic burden of PTSD.
从社会角度估算美国平民和军人中创伤后应激障碍（PTSD）的经济负担。采用基于患病率和人力资本的方法，根据保险理赔数据、学术文献和政府出版物估算2018年PTSD的总额外成本。比较了患有PTSD的成年人与未患PTSD的成年人（若无法获取未患PTSD成年人的信息，则与普通人群）之间与PTSD相关的额外直接医疗保健成本（药房、医疗）、直接非医疗保健成本（研究与培训、物质使用、心理治疗、无家可归、残疾）以及间接成本（失业、生产力损失、护理、过早死亡）。2018年美国PTSD的总额外经济负担估计为2322亿美元（每位PTSD患者19630美元）。总额外成本在平民人口中为1895亿美元（81.6%），在军人人口中为427亿美元（18.4%），分别对应平民和军人人口中每位PTSD患者18640美元和25684美元。在平民人口中，额外负担由直接医疗保健（660亿美元）和失业（427亿美元）成本驱动。在军人人口中，额外负担由残疾（178亿美元）和直接医疗保健（101亿美元）成本驱动。PTSD的经济负担不仅限于直接医疗保健成本，而且已发现与其他高成本心理健康状况的成本相当。提高对PTSD的认识、开发更有效的治疗方法以及扩大循证干预措施可能有助于减轻PTSD巨大的临床和经济负担。
