摘要
目的:从社会角度估算通辽市老年期痴呆的疾病成本,并探索社会成本的影响因素.方法:采用10/66老年期痴呆系列研究评估工具诊断老年期痴呆,并收集老年人医疗服务次数、照护者的照护时间或支出,以及照护者的照护痛苦.采用成本比例换算法参考国家统计年鉴数据估计医疗服务的次均费用,采用人力资本法估算非正式照护者照护时间的单位价值,采用意愿支付法测量照护者痛苦带来的无形成本.以2023年为参照年计算老年期痴呆的社会总成本,并使用两部分模型分析成本的影响因素.结果:本研究共诊断390例老年期痴呆患者,人均社会成本为117 877元/a.其中,非正式照护成本占比最大,达73.1％.女性患者社会成本比男性患者高61 395元.共患脑卒中的患者比没有共患的患者的社会成本高63 008元,患者每多患有一种慢性病,社会成本增加5 868元,患者每多一项临床痴呆评分量表非记忆维度损伤,社会成本增加53 997元.结论:老年期痴呆导致重大社会经济负担,非正式照护是重要的组成部分.
Abstract
Objective:To estimate the costs of dementia from a societal perspective in Tongliao City and ex-plore the influencing factors of these costs.Methods:Dementia was diagnosed using the 10/66 Dementia Research Group assessment instruments.Data on healthcare utilization,caregiver's care time or costs,and the distress due to caregiving were collected.The cost-proportion conversion method was used to estimate the per capita cost of health services based on data from the National Statistical Yearbook.The human capital approach was used to estimate the unit value of informal care time,and the willingness-to-pay method was used to measure the intangible costs of car-egivers.The total societal costs of dementia were calculated based on the reference year 2023,and a two-part model was employed to analyze the factors influencing the societal costs.Results:A total of 390 dementia patients were di-agnosed,with an average societal cost per capita of 117 877 Yuan.The largest cost component was informal care provided by unpaid family members,accounting for 73.1％of the total societal cost.The societal costs for female patients were 61 395 Yuan higher than those for male patients.Patients with comorbid stroke had a higher societal cost of 63 008 Yuan compared to patients without stroke,and each additional chronic disease added 5 868 Yuan to societal costs.Additionally,each non-memory dimension impairment in the Clinical Dementia Rating Scale in-creased the societal costs by 53 997 Yuan.Conclusion:Dementia poses a significant socio-economic burden,with informal care being the major component of this burden.
基金项目
内蒙古自治区科技计划(2022YFSH0036)
首都卫生发展科研专项(首发2020-2Z4116)
维普
万方数据