Bonneux L, Barendregt J J, Nusselder W J, der Maas P J
Department of Public Health, Erasmus University Rotterdam, The Netherlands.
BMJ. 1998 Jan 3;316(7124):26-9. doi: 10.1136/bmj.316.7124.26.
To examine whether elimination of fatal diseases will increase healthcare costs.
Mortality data from vital statistics combined with healthcare spending in a cause elimination life table. Costs were allocated to specific diseases through the various healthcare registers.
The population of the Netherlands, 1988.
Healthcare costs of a synthetic life table cohort, expressed as life time expected costs.
The life time expected healthcare costs for 1988 in the Netherlands were 56,600 Pounds for men and 80,900 Pounds for women. Elimination of fatal diseases--such as coronary heart disease, cancer, or chronic obstructive lung disease--increases healthcare costs. Major savings will be achieved only by elimination of non-fatal disease--such as musculoskeletal diseases and mental disorders.
The aim of prevention is to spare people from avoidable misery and death not to save money on the healthcare system. In countries with low mortality, elimination of fatal diseases by successful prevention increases healthcare spending because of the medical expenses during added life years.
研究消除致命疾病是否会增加医疗保健成本。
将人口动态统计中的死亡率数据与病因消除寿命表中的医疗保健支出相结合。通过各种医疗保健登记册将成本分配到特定疾病。
1988年荷兰人口。
合成寿命表队列的医疗保健成本,以终身预期成本表示。
1988年荷兰男性终身预期医疗保健成本为56,600英镑,女性为80,900英镑。消除致命疾病——如冠心病、癌症或慢性阻塞性肺病——会增加医疗保健成本。只有消除非致命疾病——如肌肉骨骼疾病和精神障碍——才能实现大幅节省。
预防的目的是使人们免受可避免的痛苦和死亡,而不是在医疗保健系统上省钱。在死亡率较低的国家,通过成功预防消除致命疾病会增加医疗保健支出,因为在增加的生命年中会产生医疗费用。