Diop Modou, Epstein David
Hospinnomics (Paris School of Economics & Assistance Publique - Hôpitaux de Paris), Hôtel Dieu 1 Parvis Notre-Dame, 75004, Paris, France.
Department of Applied Economics, University of Granada, Granada, Spain.
Pharmacoecon Open. 2024 Nov;8(6):793-808. doi: 10.1007/s41669-024-00517-3. Epub 2024 Aug 16.
To systematically review the health-related quality of life (HRQoL) burden and costs of spinal cord injury (SCI) on health services, patients and wider society.
A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement was conducted in March 2021 through Scopus, PubMed and Embase databases. Inclusion criteria were quantitative studies on SCI reporting healthcare costs, social costs and/or HRQoL measured with the Euroqol EQ-5D or Short-Form 36. Risk of bias was assessed using the QualSyst tool. Descriptive analyses, random-effects direct meta-analysis and random-effects meta-regression were conducted.
A total of 67 studies were eligible for inclusion. SCI individuals tend to report higher HRQoL in mental than physical dimensions of the Short-Form 36. Neurological level of SCI negatively affects HRQoL. Cross-sectional studies find employment is associated with better HRQoL, but the effect is not observed in longitudinal studies. The estimated lifetime expenditure per individual with SCI ranged from US$0.7 million to US$2.5 million, with greater costs associated with earlier age at injury, neurological level, United States of America healthcare setting and the inclusion of non-healthcare items in the study.
SCI is associated with low HRQoL on mobility and physical dimensions. Mental health scores tend to be greater than physical scores, and most dimensions of HRQoL appear to improve over time, at least over the first year. SCI is associated with high costs which vary by country.
This review was registered in PROSPERO (registration number: CRD42021235801).
系统评价脊髓损伤（SCI）对卫生服务、患者及更广泛社会造成的与健康相关的生活质量（HRQoL）负担和成本。
2021年3月，依据系统评价和Meta分析的首选报告项目声明进行了一项系统评价，通过Scopus、PubMed和Embase数据库进行检索。纳入标准为关于SCI的定量研究，报告了使用欧洲五维度健康量表（Euroqol EQ-5D）或简短健康调查问卷（Short-Form 36）测量的医疗保健成本、社会成本和/或HRQoL。使用QualSyst工具评估偏倚风险。进行了描述性分析、随机效应直接Meta分析和随机效应Meta回归。
共有67项研究符合纳入标准。SCI个体在简短健康调查问卷的心理维度上的HRQoL往往高于身体维度。SCI的神经学水平对HRQoL有负面影响。横断面研究发现就业与更好的HRQoL相关，但纵向研究未观察到这种影响。估计每名SCI患者的终身支出在70万美元至250万美元之间，受伤时年龄越小、神经学水平、美国的医疗保健环境以及研究中纳入非医疗保健项目会带来更高的成本。
SCI与行动能力和身体维度方面的低HRQoL相关。心理健康得分往往高于身体得分，并且HRQoL的大多数维度似乎会随时间改善，至少在第一年是这样。SCI与高昂的成本相关，成本因国家而异。
本评价在国际前瞻性系统评价注册库（PROSPERO）中注册（注册号：CRD42021235801）。
