Mitchell A J, Cogswell Ian E, Dalos Jeremy, Tsakalos Golsum, Lei Jiali, Oros Andrei, Rafferty Quinn, Santoni Serena, Steele Xaviera, Dieleman Joseph L, Apeagyei Angela E
Institute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, Seattle, WA, USA.
Institute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, Seattle, WA, USA.
Lancet Public Health. 2025 May;10(5):e401-e411. doi: 10.1016/S2468-2667(25)00089-1.
The burden of brain disorders, including neurological and mental health conditions, is rising globally. Despite the increasing burden, literature quantifying global spending patterns on care services for brain disorders is sparse. Our aim was to quantify the direct spending on health care associated with brain disorders between 2000 and 2019.
In this modelling study, we estimated direct spending for 24 brain disorders across 204 countries in males and females across 18 age groups between 2000 and 2019. We used disease prevalence and incidence from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, relative price of care estimates from the Institute for Health Metrics and Evaluation Disease Expenditure Project, and type of care-specific and country-specific adjustment factors from the National Health Accounts, to develop estimates of direct health spending on brain disorders. We adjusted our estimates using a hierarchical linear mixed-effects model regression.
We estimated US$1·7 trillion (95% uncertainty interval 1·6-1·9) in direct health-care spending on brain disorders in 2019, in which spending grew annually at 3·5% (3·2-3·7) since 2000. Direct spending on services for neurological disorders accounted for 51·8% (48·4-55·6) of total spending in 2019, in which inpatient care services represented the largest fraction of overall spending on brain health globally. Older adults aged 50-74 years had the highest spending on care services and the steepest growth. There were minimal sex differences overall.
Direct spending on brain health contributes to a substantial economic burden for societies. In light of an increasingly ageing global population, it is crucial that policy makers prioritise interventions that support households affected by brain disorders.
Roche Holdings and Genentech.
包括神经和精神健康状况在内的脑部疾病负担在全球范围内不断上升。尽管负担日益加重，但量化全球脑部疾病护理服务支出模式的文献却很稀少。我们的目标是量化2000年至2019年期间与脑部疾病相关的医疗保健直接支出。
在这项建模研究中，我们估计了2000年至2019年期间204个国家中18个年龄组的男性和女性中24种脑部疾病的直接支出。我们使用了《2023年全球疾病、伤害和风险因素负担研究》（GBD）中的疾病患病率和发病率、健康指标与评估研究所疾病支出项目的护理估计相对价格，以及国民健康账户中特定护理类型和特定国家的调整因素，来制定脑部疾病直接医疗支出的估计值。我们使用分层线性混合效应模型回归对估计值进行了调整。
我们估计2019年脑部疾病的直接医疗支出为1.7万亿美元（95%不确定区间为1.6 - 1.9万亿美元），自2000年以来支出每年增长3.5%（3.2 - 3.7%）。2019年神经疾病服务的直接支出占总支出的51.8%（48.4 - 55.6%），其中住院护理服务占全球脑部健康总支出的最大部分。50 - 74岁的老年人在护理服务上的支出最高，增长也最显著。总体而言，性别差异极小。
脑部健康的直接支出给社会带来了巨大的经济负担。鉴于全球人口老龄化日益加剧，政策制定者优先考虑支持受脑部疾病影响家庭的干预措施至关重要。
罗氏控股公司和基因泰克公司。
