University of British Columbia, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada.
University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada.
BMC Geriatr. 2022 Oct 22;22(1):815. doi: 10.1186/s12877-022-03466-w.
Functional independence limitations restrict older adult self-sufficiency and can reduce quality of life. This systematic review and cost of impairment study examined the costs of functional independence limitations among community dwelling older adults to society, the health care system, and the person.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines this systematic review included community dwelling older adults aged 60 years and older with functional independence limitations. Databases (Cochrane Database of Systematic Reviews, EconLit, NHS EED, Embase, CINAHL, AgeLine, and MEDLINE) were searched between 1990 and June 2020. Two reviewers extracted information on study characteristics and cost outcomes including mean annual costs of functional independence limitations per person for each cost perspective (2020 US prices). Quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.
85 studies were included. The mean annual total costs per person (2020 US prices) were: $27,380.74 (95% CI: [$4075.53, $50,685.96]) for societal, $24,195.52 (95% CI: [$9679.77, $38,711.27]) for health care system, and $7455.49 (95% CI: [$2271.45, $12,639.53]) for personal. Individuals with cognitive markers of functional independence limitations accounts for the largest mean costs per person across all perspectives. Variations across studies included: cost perspective, measures quantifying functional independence limitations, cost items reported, and time horizon.
This study sheds light on the importance of targeting cognitive markers of functional independence limitations as they accounted for the greatest costs across all economic perspectives.
功能独立性限制限制了老年人的自理能力，并降低了生活质量。本系统评价和损伤成本研究调查了社区居住的老年人功能独立性限制给社会、医疗保健系统和个人带来的成本。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，本系统评价纳入了年龄在 60 岁及以上、有功能独立性限制的社区居住老年人。在 1990 年至 2020 年 6 月期间，我们在以下数据库中进行了检索：Cochrane 系统评价数据库、EconLit、NHS EED、Embase、CINAHL、AgeLine 和 MEDLINE。两名评审员提取了研究特征和成本结果的信息，包括每个成本视角（2020 年美国价格）下每个人功能独立性限制的平均年度成本。使用健康经济评估报告标准（CHEERS）清单评估质量。
共纳入 85 项研究。每个人的平均年度总成本（2020 年美国价格）为：社会视角下为 27380.74 美元（95%CI：[4075.53 美元，50685.96 美元]），医疗保健系统视角下为 24195.52 美元（95%CI：[9679.77 美元，38711.27 美元]），个人视角下为 7455.49 美元（95%CI：[2271.45 美元，12639.53 美元]）。具有功能独立性限制认知标志物的个体在所有视角下的人均成本最高。研究之间的差异包括：成本视角、量化功能独立性限制的措施、报告的成本项目和时间范围。
本研究强调了针对功能独立性限制认知标志物的重要性，因为它们在所有经济视角下都造成了最大的成本。
