比利时弗拉芒地区多发性硬化症患者按残疾程度划分的专业护理与援助的使用情况及费用
Utilisation and cost of professional care and assistance according to disability of patients with multiple sclerosis in Flanders (Belgium).
作者信息
Carton H, Loos R, Pacolet J, Versieck K, Vlietinck R
机构信息
Department of Neurology, University Hospital Leuven, University of Leuven, Belgium.
出版信息
J Neurol Neurosurg Psychiatry. 1998 Apr;64(4):444-50. doi: 10.1136/jnnp.64.4.444.
OBJECTIVES
To assess the utilisation of medical services and social (community) assistance in patients with multiple sclerosis of different disability and to calculate the direct healthcare costs to society.
METHODS
(1) One hundred and eighty four patients with multiple sclerosis were classified into four grades of disability according to a simplified Kurzke disability status scale. (2) Patients were interviewed with a structured questionnaire containing questions on their sociodemographic status, the use of inpatient and outpatient medical services and pharmaceutical products during the previous year, the use of social assistance, and the purchase of prosthetics and charges for house adaptations during the previous five years. (3) Data were also prospectively collected by means of four week diary annotations of all medical and social acts and their duration.
RESULTS
After correction for the disability distribution the yearly costs for the 5500 patients with multiple sclerosis in Flanders was estimated to be ECU 13106000 for ambulatory care including rehabilitation and district nursing and ECU 3234000 for pharmaceutical products. To these direct medical costs ECU 3491000 for social assistance and ECU 4938000 for prosthetics and adaptations should be added. The yearly costs for admissions to hospital including permanent residence in an institution and pharmacy was ECU 26581000 . Home nursing and long term or permanent residence in an institution of the most severely disabled, 17% of the multiple sclerosis population, are responsible for 50% of the total direct healthcare costs and care for the 6.5% institutionalised patients accounts for 23%. Direct costs for medical care and social assistance for patients with multiple sclerosis, who account for about 0.1 % of the total population, amounts to 1% of the total healthcare budget in Flanders.
CONCLUSION
This information on utilisation of medical services and social assistance can be used for good healthcare planning and cost effectiveness studies.
目的
评估不同残疾程度的多发性硬化症患者的医疗服务利用情况及社会（社区）援助情况，并计算社会的直接医疗成本。
方法
（1）根据简化的库尔茨克残疾状态量表，将184例多发性硬化症患者分为四个残疾等级。（2）采用结构化问卷对患者进行访谈，问卷内容包括社会人口学状况、上一年住院和门诊医疗服务及药品的使用情况、社会援助的使用情况以及过去五年假肢的购买和房屋改造费用。（3）还通过对所有医疗和社会行为及其持续时间进行四周的日记记录来前瞻性收集数据。
结果
在对残疾分布进行校正后，佛兰德地区5500例多发性硬化症患者的年度费用估计为：包括康复和社区护理在内的门诊护理为13106000欧洲货币单位，药品为3234000欧洲货币单位。在这些直接医疗成本基础上，应加上3491000欧洲货币单位的社会援助费用和4938000欧洲货币单位的假肢及改造费用。包括长期住院和药房费用在内的年度住院费用为26581000欧洲货币单位。家庭护理以及最严重残疾的17%的多发性硬化症患者长期或永久住院，占直接医疗总成本的50%，而6.5%的住院患者护理费用占23%。多发性硬化症患者约占总人口的0.1%，其医疗护理和社会援助的直接成本占佛兰德地区医疗总预算的1%。
结论
这些关于医疗服务利用和社会援助的信息可用于良好的医疗规划和成本效益研究。
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