Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà n. 33, 56127, Pisa, Italy.
Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.
Eur J Health Econ. 2024 Apr;25(3):411-422. doi: 10.1007/s10198-023-01593-8. Epub 2023 May 22.
This study aims at evaluating the cost-of-illness (COI) of patients diagnosed with Behcet's syndrome (BS) in Italy, trying to depict the impact of different costs' components to the overall economic burden and analysing the variability of costs according to years since diagnosis and age at first symptoms.
With a cross-sectional evaluation, we surveyed a large sample of BS patients in Italy assessing several dimensions related to BS, also including fact related to the use of health resources utilization, formal and informal care, and productivity losses. Overall costs, direct health, direct non-health, and indirect costs were thus estimated per patient/year considering a Societal perspective and the impact of years since diagnosis, age at first symptoms on costs was evaluated using generalized linear model (GLM) and a two-part model, adjusting for age and distinguishing among employed and non-employed responders.
A total of 207 patients were considered in the present study. From the perspective of the Society, mean overall costs for BS patient were estimated to be 21,624 € (0;193,617) per patient/year. Direct non-health expenses were the main costs component accounting for 58% of the overall costs, followed direct health costs, 36%, while indirect costs because of productivity losses represented 6% of the overall costs. Being employed resulted in significantly lower overall costs (p = 0.006). Results from the multivariate regression analyses suggested that the probability of incurring in overall costs equal to zero decreased as time from BS diagnosis is 1 year or more as compared to newly diagnosed patients (p < 0.001); while among those incurring in expenses, costs decreased for those experiencing first symptoms between 21 and 30 years (p = 0.027) or later (p = 0.032) as compared to those having symptoms earlier. Similar findings emerged among the subgroups of patients declaring themselves as workers, while no impact of years since diagnosis or age of first symptoms was found among non-workers.
The present study offers a comprehensive overview of the economic consequences imposed by BS in a societal perspective, providing insights into the distribution of the different costs component related to BS, thus helping the development of targeted policies.
本研究旨在评估意大利贝赫切特综合征(BS)患者的疾病成本(COI),尝试描述不同成本构成对总体经济负担的影响,并根据诊断后时间和首次症状年龄分析成本的可变性。
采用横断面评估,我们对意大利的大量 BS 患者进行了调查,评估了与 BS 相关的多个维度,包括与卫生资源利用、正规和非正规护理以及生产力损失相关的事实。因此,从社会角度考虑,根据每位患者/年估计了总体成本、直接医疗、直接非医疗和间接成本,并使用广义线性模型(GLM)和两部分模型评估了诊断后时间和首次症状年龄对成本的影响,该模型调整了年龄,并区分了就业和非就业应答者。
本研究共纳入 207 例患者。从社会角度来看,BS 患者的平均总费用估计为每位患者/年 21624 欧元(0;193617)。非医疗直接费用是主要的成本构成部分,占总费用的 58%,其次是直接医疗费用,占 36%,而生产力损失导致的间接费用占总费用的 6%。就业状态与较低的总费用显著相关(p=0.006)。多变量回归分析结果表明,与新诊断患者相比,BS 诊断后 1 年或以上的患者发生总费用为零的概率降低(p<0.001);而对于发生费用的患者,首次症状在 21-30 岁(p=0.027)或之后(p=0.032)的患者,其费用降低。在自称为劳动者的患者亚组中也出现了类似的发现,而在非劳动者中,诊断后时间或首次症状年龄没有影响。
本研究从社会角度全面概述了 BS 带来的经济后果,深入了解了与 BS 相关的不同成本构成的分布情况,从而有助于制定有针对性的政策。