Chrischilles E A, Rubenstein L M, Voelker M D, Wallace R B, Rodnitzky R L
Department of Preventive Medicine and Environmental Health, The University of Iowa, Iowa City 52242, USA.
Mov Disord. 1998 May;13(3):406-13. doi: 10.1002/mds.870130306.
Parkinson's disease (PD) is likely to have a substantial impact on an individual's health-related quality of life (HRQL), health-related resource use, and productivity. Data about the health burdens of PD by disease stage are fundamental to understanding the effectiveness of care, both from a clinical and a fiscal point of view. This study's goal was to describe the associations of patient-reported HRQL and economic characteristics with PD stage. We hypothesized that later stages of PD would be associated with poorer HRQL, greater health-related resource use, and lower work productivity than early stages of PD. We used a cross-sectional analysis to study 193 PD patients attending two hospital-based neurology clinics. Self-administered questionnaires and in-person interviews measured clinical features, functional status, general health perceptions, well-being, overall HRQL, work productivity, and health-related resource use. Consistent, strong associations were found between stage and functional status, general health perceptions, well-being, and overall HRQL even after controlling for age, gender, and comorbid conditions. Most resource use and work productivity measures were also associated with disease stage. However, physician services use was not. This study confirms that the burdens of illness are progressively higher for PD patients with early, moderate, and advanced illness. The results suggest that such important facets of the health burden as HRQL and health-related resource use may be seriously misjudged if not carefully measured but inferred from clinical observations alone.
帕金森病（PD）可能会对个人的健康相关生活质量（HRQL）、健康相关资源利用和生产力产生重大影响。从临床和财政角度来看，按疾病阶段划分的帕金森病健康负担数据对于理解护理效果至关重要。本研究的目的是描述患者报告的健康相关生活质量和经济特征与帕金森病阶段之间的关联。我们假设，与帕金森病早期相比，晚期帕金森病会导致更差的健康相关生活质量、更多的健康相关资源利用以及更低的工作生产力。我们采用横断面分析方法，对在两家医院神经内科诊所就诊的193名帕金森病患者进行了研究。通过自行填写问卷和面对面访谈来测量临床特征、功能状态、总体健康认知、幸福感、整体健康相关生活质量、工作生产力以及健康相关资源利用情况。即使在控制了年龄、性别和合并症之后，仍发现疾病阶段与功能状态、总体健康认知、幸福感以及整体健康相关生活质量之间存在一致且强烈的关联。大多数资源利用和工作生产力指标也与疾病阶段相关。然而，医生服务的使用情况并非如此。本研究证实，帕金森病早期、中期和晚期患者的疾病负担逐渐加重。结果表明，如果不进行仔细测量而仅从临床观察推断，那么健康负担的这些重要方面，如健康相关生活质量和健康相关资源利用，可能会被严重误判。
