Smith D H, Malone D C, Lawson K A, Okamoto L J, Battista C, Saunders W B
Department of Pharmacy, University of Washington, Seattle 98195, USA.
Am J Respir Crit Care Med. 1997 Sep;156(3 Pt 1):787-93. doi: 10.1164/ajrccm.156.3.9611072.
This cost of illness analysis examines national cost and resource utilization by persons with asthma using a single, comprehensive data source, the 1987 National Medical Expenditure Survey. Direct medical expenditures included payments for ambulatory care visits, hospital outpatient services, hospital inpatient stays, emergency department visits, physician and facility payments, and prescribed medicines. Indirect medical costs included costs resulting from missed work or school and days with restricted activity at work. Point estimates and 95% confidence intervals (CI) were calculated and inflated to 1994 dollars. The total estimated cost was $5.8 billion (95% CI, $3.6 to $8 billion). The estimated direct expenditures were $5.1 billion (95% CI, $3.3 to $7.0 billion), and indirect expenditures were valued at $673 million (95% CI, $271 to $1,076 million). Hospitalization accounted for more than half of all expenditures. More than 80% of resources were used by 20% of the population (defined as 'high-cost patients'). The estimated annual per patient cost for those high-cost patients was $2,584, in contrast with $140 for the rest of the sample. Findings from this study indicate that future asthma research and intervention efforts directed at hospitalizations and high-cost patients could help to decrease health care resource use and provide cost savings.
这项疾病成本分析利用单一的综合数据源——1987年全国医疗支出调查，研究了哮喘患者的全国成本和资源利用情况。直接医疗支出包括门诊就诊费用、医院门诊服务费用、住院费用、急诊就诊费用、医生和医疗机构费用以及处方药费用。间接医疗成本包括因旷工、缺课以及工作中活动受限天数所产生的成本。计算了点估计值和95%置信区间（CI），并换算为1994年美元价值。估计总成本为58亿美元（95% CI，36亿美元至80亿美元）。估计直接支出为51亿美元（95% CI，33亿美元至70亿美元），间接支出为6.73亿美元（95% CI，2.71亿美元至10.76亿美元）。住院费用占所有支出的一半以上。超过80%的资源由20%的人群（定义为“高成本患者”）使用。这些高成本患者的估计人均年度成本为2584美元，而样本中其他患者为140美元。这项研究的结果表明，未来针对住院治疗和高成本患者的哮喘研究及干预措施可能有助于减少医疗资源的使用并节省成本。
