Mennini Francesco Saverio, Sciattella Paolo, Scortichini Matteo
Economic Evaluation and HTA (EEHTA-CEIS), DEF Department, Faculty of Economics, University of Rome 'Tor Vergata', Rome - Italy.
Department of Accounting and Finance, Kingston University, London - UK.
Glob Reg Health Technol Assess. 2022 Jun 28;9(Suppl 2):10-13. doi: 10.33393/grhta.2022.2427. eCollection 2022 Jan-Dec.
The World Health Assembly recognizes the growing economic and societal burden of neurological disorders, a leading cause of disability and the second cause of mortality in the world. In this context we analysed the socio-economic impact of epilepsy in Italy with a specific focus on hospitalizations and costs related to disability pensions (DPs) and ordinary disability allowances. In the case of epilepsy, between 2009 and 2015 we observed an alarming increasing trend for DPs (+26%), indicating that substantial expenses must be supported throughout the patients' lifetimes by both the social security system and the National Health Service (NHS) on top of the impact on caregivers. We also analysed the hospital expenditure on epilepsy through the information available in the Hospital Discharge Cards between 2015 and 2018. Almost all admissions (76% ordinary hospitalizations, 24% day hospitals) were acute (95%), followed by rehabilitation (4%) and long-term care (1%). The cost of acute and ordinary hospitalizations was by far the highest in 2018, the last year of analysis. This large expense due to hospitalizations could be reduced through the implementation of different organizational and management approaches. Our recommendation is that the policy maker should consider the best approach to ensure an early diagnosis for patients and provide early access to drugs and/or surgery. Finally, the adoption of new innovative treatments should improve effectiveness and, at the same time, reduce the expense of the NHS, of the social system as a whole, with a tangible improvement in patients' quality of life.
世界卫生大会认识到神经疾病日益加重的经济和社会负担，神经疾病是导致残疾的主要原因，也是全球第二大致死原因。在此背景下，我们分析了癫痫在意大利造成的社会经济影响，特别关注住院情况以及与残疾抚恤金（DPs）和普通残疾津贴相关的费用。就癫痫而言，在2009年至2015年期间，我们观察到残疾抚恤金出现了惊人的增长趋势（增长了26%），这表明除了对护理人员的影响之外，社会保障系统和国家医疗服务体系（NHS）在患者的整个生命周期内都必须承担巨额费用。我们还通过2015年至2018年医院出院卡中的可用信息分析了癫痫的医院支出情况。几乎所有入院病例（76%为普通住院，24%为日间医院）都是急性的（95%），其次是康复治疗（4%）和长期护理（1%）。在分析的最后一年即2018年，急性和普通住院的费用是最高的。通过实施不同的组织和管理方法，可以减少因住院造成的这笔巨额费用。我们建议政策制定者应考虑最佳方法，以确保对患者进行早期诊断，并使其能够尽早获得药物和/或手术治疗。最后，采用新的创新疗法应能提高疗效，同时降低NHS以及整个社会系统的费用，并切实改善患者的生活质量。
