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健康保险和资源对全球人口中阿尔茨海默病及相关痴呆症负担的影响。

The impacts of health insurance and resource on the burden of Alzheimer's disease and related dementias in the world population.

作者信息

Wang Jin-Tao, Xu Gang, Ren Ru-Jing, Wang Ying, Tang Ran, Huang Qiang, Li Jian-Ping, Al-Nusaif Murad, Le Wei-Dong, Wang Gang

机构信息

Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

School of Public Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China.

出版信息

Alzheimers Dement. 2023 Mar;19(3):967-979. doi: 10.1002/alz.12730. Epub 2022 Jul 12.

Abstract

INTRODUCTION

The increasing prevalence of Alzheimer's disease and related dementias (ADRD) presents both a burden and an opportunity for intervention. This study aims to estimate the impacts of health insurance and resources on the burden attributed to ADRD.

METHOD

Data were mainly collected from global databases for ADRD. Analysis of variance, Pearson correlation, random-effects, and fixed-effects model analyses were used in this study.

RESULTS

Although the current medical expenditures were increasing and out of pocket (OOP) expenditures were declining generally in various countries, the collected global data showed an increased burden of ADRD on patients both physically and economically. Furthermore, health resources were negatively associated with disability-adjusted life years (DALY), death, and years of life lost (YLL), but were otherwise positively associated with years of life lived with disability (YLD).

DISCUSSION

Effective measures should be considered to cope with the rising burden. Meanwhile, there is an urgent call for constructive and sustainable rational plans and global collaboration.

HIGHLIGHTS

We explored how health insurance and resources affect Alzheimer's disease and related dementias (ADRD)-related burden. Health insurance and resources were imbalanced among four income level groups. Health insurance and resources may decrease the total ADRD burden primarily from a reduction in death-related burden. Health insurance and resources may increase disability-related burden.

摘要

引言

阿尔茨海默病及相关痴呆症(ADRD)的患病率不断上升,这既带来了负担,也提供了干预机会。本研究旨在评估医疗保险和资源对ADRD所致负担的影响。

方法

数据主要从全球ADRD数据库收集。本研究采用方差分析、Pearson相关性分析、随机效应模型分析和固定效应模型分析。

结果

尽管目前各国的医疗支出在增加,自付费用总体上在下降,但所收集的全球数据显示,ADRD给患者带来的身体和经济负担都在增加。此外,卫生资源与伤残调整生命年(DALY)、死亡和寿命损失年数(YLL)呈负相关,但与残疾生存年数(YLD)呈正相关。

讨论

应考虑采取有效措施应对不断上升的负担。与此同时,迫切需要制定建设性和可持续的合理计划并开展全球合作。

要点

我们探讨了医疗保险和资源如何影响阿尔茨海默病及相关痴呆症(ADRD)相关负担。医疗保险和资源在四个收入水平组之间不均衡。医疗保险和资源可能主要通过减轻与死亡相关的负担来降低ADRD总负担。医疗保险和资源可能会增加与残疾相关的负担。

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