Torres-Granados Gustavo Ivan, Santana-Miranda Rafael, Barrera-Medina Andrés, Cruz-Cruz Copytzy, Jiménez-Correa Ulises, Rosenthal Leon, López-Naranjo Francisco, Martínez-Núñez Juan Manuel
Department of Biological Systems, Universidad Autónoma Metropolitana, Campus Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, 04960 Coyoacán, Mexico City, Mexico.
Clinic of Sleep Disorders, Research Division, School of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.
Sleep Biol Rhythms. 2023;21(1):23-31. doi: 10.1007/s41105-022-00412-6. Epub 2022 Aug 12.
Significant advances documenting the costs associated with insomnia have been achieved. However, those related to insomnia associated with mood disorders remain understudied, even though insomnia is more severe in the presence of comorbid conditions such as depression and anxiety. The aim of this study was to determine the direct and indirect costs of insomnia associated with depression and anxiety disorders (DAD) from the perspective of the patient in a private healthcare system. This was an observational study of chronic insomnia associated with DAD at a private Sleep Disorders Clinic in Mexico City between 2019 and 2020. Patients were followed for up to one year. Healthcare resource utilization data were collected through clinical records. Direct and indirect costs associated with insomnia treatment were estimated through micro-costing. The estimated economic burden was projected to 5 years adjusting for inflation and discounting future costs. A deterministic sensitivity analysis was performed. The median cost of the first year of insomnia treatment associated with DAD was US$3537.57 per patient. The work productivity loss represented the highest economic burden (63.84%) followed by direct medical costs (28.32%), and the direct non-medical costs (7.85%). The estimated annual economic burden for patients treated in the private healthcare system in Mexico was US$293 million. The costs of insomnia associated with DAD at a private clinic in México were found to be high. The burden of the costs faced by these patients is substantial relative to the median income of the population. The economic costs at an individual and societal levels are substantial.
The online version contains supplementary material available at 10.1007/s41105-022-00412-6.
在记录失眠相关成本方面已取得重大进展。然而,与情绪障碍相关的失眠问题仍未得到充分研究,尽管在存在抑郁症和焦虑症等共病的情况下失眠更为严重。本研究的目的是从私立医疗系统中患者的角度确定与抑郁和焦虑障碍(DAD)相关的失眠的直接和间接成本。这是一项对2019年至2020年期间墨西哥城一家私立睡眠障碍诊所中与DAD相关的慢性失眠的观察性研究。对患者进行了长达一年的随访。通过临床记录收集医疗资源利用数据。通过微观成本核算估计与失眠治疗相关的直接和间接成本。根据通货膨胀情况对估计的经济负担进行调整,并对未来成本进行贴现,预测到5年。进行了确定性敏感性分析。与DAD相关的失眠治疗第一年的中位成本为每位患者3537.57美元。工作生产力损失占最高的经济负担(63.84%),其次是直接医疗成本(28.32%)和直接非医疗成本(7.85%)。墨西哥私立医疗系统中接受治疗的患者估计年度经济负担为2.93亿美元。发现墨西哥一家私立诊所中与DAD相关的失眠成本很高。相对于人口中位数收入而言,这些患者面临的成本负担巨大。个人和社会层面的经济成本都很高。
在线版本包含可在10.1007/s41105-022-00412-6获取的补充材料。