Tinazzi Michele, Gandolfi Marialuisa, Menaspà Zoe, Sandri Angela, Landi Stefano, Leardini Chiara
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Department of Management, University of Verona, Verona, Italy.
Neurol Sci. 2025 Mar;46(3):1191-1200. doi: 10.1007/s10072-024-07865-2. Epub 2024 Nov 13.
Functional motor disorders (FMDs) are prevalent and highly disabling conditions among young adults, leading to reduced independence. Despite advancements in diagnosis and treatment, the economic burden of FMDs remains largely unknown.
This study evaluates the impact of accurate FMDs diagnosis on direct healthcare costs within the Italian National Health System by comparing healthcare utilization and costs before and after diagnosis.
This before-after study included 40 patients with a definite diagnosis of FMDs. Retrospective data on healthcare utilization, including diagnostic tests, specialist visits, hospitalizations, Emergency Room (ER) visits, and rehabilitation services, were collected from diaries and documents two years before and after diagnosis.
Healthcare direct costs decreased by 67%, from an average of €4,467 [95% CI 3,604-5,329] to €1,461 [95% CI 945-1,976] after diagnosis. Hospitalization costs fell from €2,618 [95% CI 1,899-3,336] to €492 [95% CI 162-821], and ER costs dropped from €403 [95% CI 177-628] to €43 [95% CI 6-78]. Diagnostic procedure costs decreased significantly, from €403 [95% CI 177-628] to €43 [95% CI 6-78]. Specialist visit costs remained unchanged. Rehabilitation costs increased from €371 [95% CI 194-547] to €635 [95% CI 318-915], but this rise was not statistically significant.
Accurate diagnosis of FMDs significantly reduces healthcare costs by minimizing unnecessary tests, hospitalizations, and ER visits while emphasizing rehabilitation. This highlights the economic and clinical benefits of improved diagnostic accuracy and specific multidisciplinary intervention. Investing in cost-effective diagnostic tools is crucial for earlier diagnosis and reducing delays.
功能性运动障碍(FMDs)在年轻人中普遍存在且致残性很高,会导致独立性下降。尽管在诊断和治疗方面取得了进展,但FMDs的经济负担在很大程度上仍不为人知。
本研究通过比较诊断前后的医疗服务利用情况和成本,评估准确诊断FMDs对意大利国家卫生系统内直接医疗成本的影响。
这项前后对照研究纳入了40例确诊为FMDs的患者。从诊断前后两年的日记和文件中收集了关于医疗服务利用的回顾性数据,包括诊断检查、专科就诊、住院、急诊室(ER)就诊和康复服务。
医疗直接成本下降了67%,从诊断前的平均4467欧元[95%置信区间3604 - 5329]降至诊断后的1461欧元[95%置信区间945 - 1976]。住院成本从2618欧元[95%置信区间1899 - 3336]降至492欧元[95%置信区间162 - 821],急诊室成本从403欧元[95%置信区间177 - 628]降至43欧元[95%置信区间6 - 78]。诊断程序成本显著下降,从403欧元[95%置信区间177 - 628]降至43欧元[95%置信区间6 - 78]。专科就诊成本保持不变。康复成本从371欧元[95%置信区间194 - 547]增至635欧元[95%置信区间318 - 915],但这种增长无统计学意义。
准确诊断FMDs通过尽量减少不必要的检查、住院和急诊室就诊,同时强调康复,显著降低了医疗成本。这凸显了提高诊断准确性和特定多学科干预的经济和临床益处。投资于具有成本效益的诊断工具对于早期诊断和减少延误至关重要。