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疾病的经济成本:1975财年

The economic cost of illness: fiscal 1975.

作者信息

Berk A, Paringer L, Mushkin S J

出版信息

Med Care. 1978 Sep;16(9):785-90. doi: 10.1097/00005650-197809000-00009.

Abstract

In 1963, Rice estimated the costs of illness and then allocated these costs by disease. She and Cooper in 1972 updated the original estimates and developed a more sophisticated methodological approach. This paper updates further the costs of illness to 1975 and presents further methodological changes. Analysis of the direct and indirect costs of illness for 1975 reveals that the upward trend into total costs continued, reaching $264 billion. The indirect costs are loss of earnings due to morbidity or premature mortality estimated at various discount rates allocated into 18 categories by disease. The direct costs include such payments as those made for hospital care, physician services, and drugs which are allocated by disease and unallocated costs such as construction and research. The proportion of total costs due to premature mortality were found to drop slightly from 1972 to 1975, while the morbidity share increased slightly. Direct costs account for approximately the same share of total illness in 1975 as in 1972. The proportion of total costs accounted for by direct costs varies directly with the discount rate selected, with the direct costs accounting for 50 per cent of the total at the 10 per cent discount rates and 37 per cent at 2.5 per cent rate. The proportion due to morbidity costs also varies directly with the discount rate, although the changes are small. There is an inverse relationship between the share for premature mortality costs and discount rate.

摘要

1963年,赖斯估算了疾病成本,然后按疾病分配这些成本。1972年,她与库珀更新了最初的估算,并开发了一种更为精细的方法。本文进一步将疾病成本更新至1975年,并介绍了更多方法上的变化。对1975年疾病直接成本和间接成本的分析表明,总成本呈上升趋势,达到2640亿美元。间接成本是因发病或过早死亡导致的收入损失,按不同贴现率估算,并按疾病分为18类。直接成本包括医院护理、医生服务和药品等方面的支出,这些支出按疾病分配,还有未分配成本,如建设和研究成本。研究发现,过早死亡导致的总成本比例从1972年到1975年略有下降,而发病成本所占比例略有上升。1975年直接成本在疾病总成本中所占份额与1972年大致相同。直接成本在总成本中所占比例与所选贴现率直接相关,在10%贴现率下,直接成本占总成本的50%,在2.5%贴现率下占37%。发病成本所占比例也与贴现率直接相关,不过变化较小。过早死亡成本所占份额与贴现率呈反比关系。

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