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伊朗老年人心血管疾病的经济负担:来自发展中国家的案例。

Economic burden of cardiovascular diseases among elderly patients in Iran: a case from a developing country.

机构信息

Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

BMC Health Serv Res. 2024 Nov 6;24(1):1355. doi: 10.1186/s12913-024-11808-0.

Abstract

BACKGROUND

Cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity worldwide, particularly among the aging population. This study aims to evaluate the economic burden of CVDs among Iranians aged 60 years and older.

METHODS

A cost-of-illness study was conducted using a prevalence-based approach from a societal perspective. Cost analysis employed the bottom-up micro-costing method to assess direct medical and non-medical costs, while indirect costs were calculated using the human capital approach. Data were sourced from medical records of individuals aged 60 and older with CVDs registered in the hospital information systems of public and private hospitals in southeastern Iran. Additionally, structured face-to-face interviews were conducted with 160 caregivers or relatives serving as companions of elderly patients, using a structured questionnaire to gather data on healthcare utilization. Sensitivity analyses were performed, along with projections of the future economic burden of CVDs.

RESULTS

The annual total cost of CVDs among people aged 60 years and above in Iran was estimated at US$ 1,885,091,171.7 (about 1.88 billion), equivalent to 1.27% of the Iran's GDP in 2021. Direct medical costs accounted for 90.62% of the total, with 54.72% attributed to ambulatory care. The average cost of CVDs per patient was US$ 446.2. The results of two-way sensitivity analysis provided an estimated cost range between US$ 1.2 billion and US$ 2.7 billion. By 2030, the total cost of CVDs is projected to reach US$ 21 billion.

CONCLUSIONS

The elderly population with CVDs imposes a growing economic burden on Iran's healthcare system and society. This underscores the urgent need for effective and cost-effective interventions to prevent and manage CVDs in Iran.

摘要

背景

心血管疾病(CVDs)是全球范围内导致死亡和发病的主要原因,尤其是在老年人群中。本研究旨在评估伊朗 60 岁及以上老年人 CVD 的经济负担。

方法

采用基于患病率的方法,从社会角度进行疾病成本研究。成本分析采用自下而上的微观成本法评估直接医疗和非医疗费用,而间接费用则采用人力资本法计算。数据来源于伊朗东南部公立和私立医院医院信息系统中登记的 60 岁及以上 CVD 患者的医疗记录。此外,还对 160 名老年患者的护理人员或家属进行了结构化面对面访谈,使用结构化问卷收集医疗保健利用数据。进行了敏感性分析,并对 CVD 的未来经济负担进行了预测。

结果

伊朗 60 岁及以上人群 CVD 的年总成本估计为 188.5091171.7 美元(约 18.85 亿美元),相当于 2021 年伊朗 GDP 的 1.27%。直接医疗费用占总成本的 90.62%,其中 54.72%归因于门诊护理。每位患者 CVD 的平均费用为 446.2 美元。双向敏感性分析的结果提供了估计成本范围在 12 亿美元至 27 亿美元之间。到 2030 年,CVD 的总成本预计将达到 210 亿美元。

结论

患有 CVD 的老年人群给伊朗的医疗保健系统和社会带来了日益增长的经济负担。这突显出迫切需要在伊朗采取有效和具有成本效益的干预措施来预防和管理 CVD。

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