肯尼亚 2 型糖尿病给公共医疗体系带来的经济负担：一项疾病成本研究。

The economic burden of type 2 diabetes on the public healthcare system in Kenya: a cost of illness study.

机构信息

Chronic Diseases Management Unit, African Population Health Research Center, Nairobi, Kenya.

Department of Public and Occupational Health, Amsterdam Medical Centre, Amsterdam, The Netherlands.

出版信息

BMC Health Serv Res. 2024 Oct 14;24(1):1228. doi: 10.1186/s12913-024-11700-x.

DOI:10.1186/s12913-024-11700-x

PMID:39402597

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11472539/

Abstract

BACKGROUND

The burden of chronic non-communicable diseases (NCDs) is a growing public health concern. The availability of cost-of-illness data, particularly public healthcare costs for NCDs, is limited in Sub-Saharan Africa (SSA), yet such data evidence is needed for policy action.

OBJECTIVE

The objective of this study was to estimate the economic burden of type 2 diabetes (T2D) on Kenya's public healthcare system in 2021 and project costs for 2045.

METHODS

This was a cost-of-illness study using the prevalence-based bottom-up costing approach to estimate the economic burden of T2D in the year 2021. We further conducted projections on the estimated costs for the year 2045. The costs were estimated corresponding to the care, treatment, and management of diabetes and some diabetes complications based on the primary data collected from six healthcare facilities in Nairobi and secondary costing data from previous costing studies in low and middle-income countries (LMICs). The data capture and costing analysis were done in Microsoft Excel 16, and sensitivity analysis was conducted on all the parameters to estimate the cost changes.

RESULTS

The total cost of managing T2D for the healthcare system in Kenya was estimated to be US$ 635 million (KES 74,521 million) in 2021. This was an increase of US$ 2 million (KES 197 million) considering the screening costs of undiagnosed T2D in the country. The major cost driver representing 59% of the overall costs was attributed to T2D complications, with nephropathy having the highest estimated costs of care and management (US$ 332 million (KES 36, 457 million). The total cost for T2D was projected to rise to US$ 1.6 billion (KES 177 billion) in 2045.

CONCLUSION

This study shows that T2D imposes a huge burden on Kenya's healthcare system. There is a need for government and societal action to develop and implement policies that prevent T2D, and appropriately plan care for those diagnosed with T2D.

摘要

背景

慢性非传染性疾病（NCDs）的负担是一个日益严重的公共卫生问题。在撒哈拉以南非洲（SSA），疾病成本数据（特别是 NCD 公共医疗保健成本）的可用性有限，但政策行动需要此类数据证据。

目的

本研究旨在估计 2021 年肯尼亚公共医疗保健系统中 2 型糖尿病（T2D）的经济负担，并预测 2045 年的成本。

方法

这是一项基于患病率的成本效益研究，采用自下而上的成本估算方法来估算 2021 年 T2D 的经济负担。我们进一步对 2045 年的估计成本进行了预测。这些成本是根据从内罗毕的六家医疗保健机构收集的主要数据以及来自中低收入国家（LMICs）的先前成本估算研究的次要成本数据，对应于糖尿病及其一些并发症的护理、治疗和管理来估算的。数据采集和成本分析在 Microsoft Excel 16 中完成，对所有参数进行了敏感性分析，以估算成本变化。

结果

2021 年，肯尼亚医疗保健系统管理 T2D 的总成本估计为 6.35 亿美元（KES 745.21 亿）。考虑到该国未确诊 T2D 的筛查成本，这一数字增加了 200 万美元（KES 1.97 亿）。代表总体成本的 59%的主要成本驱动因素归因于 T2D 并发症，其中肾病的护理和管理估计费用最高（3.32 亿美元（KES 3645.7 亿））。到 2045 年，T2D 的总成本预计将上升至 16 亿美元（KES 1770 亿）。