Yelin E
Arthritis Foundation and the Rosalind Russell Arthritis Center at UCSF, San Fransisco, USA.
J Rheumatol Suppl. 1996 Mar;44:47-51.
We determined the average medical and indirect costs of rheumatoid arthritis (RA) from clinical and community based samples and compared those costs to those experienced by similar persons without RA. We reviewed the literature and analyzed the UCSF RA Panel Study and the National Health Interview Survey for the years 1989-91. The annual medical care costs of RA ranged from $4,300 to $5,700 in 1994 terms in the clinical samples, with hospital admissions accounting for half to two-thirds of the total. Indirect costs in the clinical samples exceeded direct costs and ranged from just under $10,000 to more than $16,000 a year. Medical care costs of RA are highly skewed, with persons in the 90th percentile experiencing costs more than 100 times as large as those in the 10th. In the national community based sample, the costs of RA amounted to $8.74 billion, of which more than half was due to medical care. In this sample, the increment of costs experienced by persons with RA compared to those without was $3.07 billion, with 80% of the excess the result of indirect costs due to wage losses.
我们从临床样本和社区样本中确定了类风湿性关节炎（RA）的平均医疗成本和间接成本，并将这些成本与没有患RA的类似人群的成本进行了比较。我们查阅了文献，并分析了1989 - 1991年的加州大学旧金山分校类风湿性关节炎专题研究以及国民健康访谈调查。以1994年的价格计算，临床样本中RA的年度医疗费用在4300美元至5700美元之间，其中住院费用占总费用的一半至三分之二。临床样本中的间接成本超过了直接成本，每年从略低于10000美元到超过16000美元不等。RA的医疗费用高度不均衡，第90百分位的人群所花费的成本是第10百分位人群的100倍以上。在全国社区样本中，RA的成本总计87.4亿美元，其中一半以上是医疗费用。在这个样本中，患RA的人群与未患RA的人群相比，成本增量为30.7亿美元，其中80%的超额成本是由于工资损失导致的间接成本。
