成人特应性皮炎的社会成本及健康相关生活质量。
Societal costs and health related quality of life in adult atopic dermatitis.
机构信息
Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, Budapest, H-1093, Hungary.
Department of Dermatology, Venereology, and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
出版信息
BMC Health Serv Res. 2023 Aug 14;23(1):859. doi: 10.1186/s12913-023-09840-7.
BACKGROUND
Cost-of-illness studies are widely used for healthcare decision-making in chronic conditions. Our aim was to assess the cost-of-illness of adult atopic dermatitis (AD) from the societal perspective in Hungary.
METHODS
We conducted a multicentre, cross-sectional questionnaire survey between February 2018 and January 2021. Data was collected from consecutive AD patients aged ≥ 18 years and their physicians at dermatology departments in Hungary. We calculated direct and indirect costs, including costs for treatments, outpatient visits, hospital admissions, informal care, travel costs and productivity loss. To assess indirect costs, the Work Productivity and Activity Impairment (WPAI) questionnaire was used to collect data, and costs were estimated with the human capital approach. Generalized linear model was used to analyse predictors of total, direct and indirect costs.
RESULTS
Altogether 218 patients completed the survey (57.8% female) with an average age of 31.3 (SD = 11.7). Patients' average Dermatology Life Quality Index (DLQI) score was 13.5 (SD = 8.5). According to Eczema Area and Severity Index (EASI) score, 2.3% (n = 5), 21.2% (n = 46), 54.4% (n = 118) and 22.1% (n = 48) had clear, mild, moderate, and severe AD, respectively. We found that the average total, direct medical, direct non-medical and indirect annual costs per patients were €4,331, €1,136, €747, and €2450, respectively, with absenteeism and presenteeism being the main cost drivers, accounting for 24% and 29% of the total cost of AD. A one-year longer disease duration led to, on average, 1.6%, and 4.2% increase in total and direct non-medical costs, respectively. Patients with worse health-related quality of life (higher DLQI score) had significantly higher total, direct medical, direct non-medical costs, and indirect costs.
CONCLUSIONS
Our results indicate a substantial economic burden of AD from a societal perspective, mainly driven by productivity losses.
背景
疾病经济负担研究广泛应用于慢性病的医疗保健决策。我们的目的是从匈牙利的社会角度评估成人特应性皮炎（AD）的疾病经济负担。
方法
我们于 2018 年 2 月至 2021 年 1 月期间进行了一项多中心、横断面问卷调查。数据来自匈牙利皮肤科部门连续就诊的年龄≥18 岁的 AD 患者及其医生。我们计算了直接和间接成本，包括治疗、门诊就诊、住院、非正式护理、旅行费用和生产力损失的费用。为了评估间接成本，使用工作生产力和活动障碍（WPAI）问卷收集数据，并使用人力资本方法估计成本。使用广义线性模型分析总费用、直接费用和间接费用的预测因素。
结果
共有 218 名患者完成了调查（57.8%为女性），平均年龄为 31.3（标准差=11.7）。患者平均皮肤病生活质量指数（DLQI）得分为 13.5（标准差=8.5）。根据湿疹面积和严重程度指数（EASI）评分，2.3%（n=5）、21.2%（n=46）、54.4%（n=118）和 22.1%（n=48）的患者分别为轻度、轻度、中度和重度 AD。我们发现，每位患者的平均总费用、直接医疗费用、直接非医疗费用和间接年度费用分别为 4331 欧元、1136 欧元、747 欧元和 2450 欧元，旷工和出勤障碍是主要的成本驱动因素，占 AD 总费用的 24%和 29%。疾病持续时间增加一年，平均会导致总费用和直接非医疗费用分别增加 1.6%和 4.2%。健康相关生活质量较差（DLQI 评分较高）的患者总费用、直接医疗费用、直接非医疗费用和间接费用显著更高。
结论
我们的研究结果表明，从社会角度来看，AD 给社会带来了巨大的经济负担，主要是由生产力损失驱动的。
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