Measuring the indirect and direct costs of acute otitis media
Measuring the indirect and direct costs of acute otitis media
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DOI：
10.1001/archotol.125.1.12
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发表时间：
1999-01-01
影响因子：
--
通讯作者：
Gates, GA
中科院分区：
文献类型：
--
作者：
Alsarraf, R;Jung, CJ;Gates, GA
目的：测试一种测量急性中耳炎（AOM）相关费用的方法，并初步计算与单一急性中耳炎医学治疗相关的间接和直接费用。设计：在一项前瞻性队列研究中，使用中耳炎日记来测量与中耳炎相关的间接和直接成本。测量值包括父母花在特定中耳炎儿童护理上的时间，以及所使用药物的数量和类型。先前开发的经济模型被用来计算与护理时间价值和AOM的总机会成本相关的货币成本。地点：华盛顿州塔科马市马迪根陆军医疗中心儿科诊所。患者：25名1至3岁的儿童（12名AOM患儿，13名对照组）。主要结局指标：照顾者时间和药物使用情况。结果：诊断后3个月内，AOM的总成本为1330.58美元（95%可信区间为1008.75- 1652.43美元），其中大部分成本来自间接而非直接的疾病成本。保守估计未测量的费用，如诊所就诊和交通费用，计入后，间接成本，主要由父母时间累积，占与AOM及其医疗相关的3个月总成本的近90%（95%置信区间，87.1%-92.3%）。中耳炎日记的费用项目彼此之间以及与临床和功能健康状况的其他措施高度相关。结论：在本成本-效果分析中，中耳炎日记测量父母时间和药物使用似乎提供了一种更准确的方法来计算AOM疾病过程中可归因于的实际社会成本。
Objectives: To test a method of measuring the related cost of acute otitis media (AOM) and to provide a preliminary calculation of the indirect and directs costs associated with a single, medically treated episode of AOM.Design: The Otitis Media Diary was used to measure indirect and direct costs associated with AOM in a prospective cohort study. Measured values included the parental time spent in otitis-specific child care and the number and type of medications used. A previously developed economic model was used to calculate the monetary costs associated with the value of caregiver time and the total opportunity cost of AOM.Setting: The pediatric clinic of Madigan Army Medical Center, Tacoma, Wash.Patients: A cohort of 25 children (12 with AOM and 13 controls) aged 1 to 3 years.Main Outcome Measures: Caregiver time and medication use.Results: The total cost attributable to AOM in the 3-month period following diagnosis was $1330.58 (95% confidence interval, $1008.75-$1652.43), with the majority of that cost stemming from the indirect, rather than direct, costs of illness. After conservative estimates of unmeasured expenses, such as clinic visits and transportation, were accounted for, indirect costs, accrued primarily by parental time, accounted for nearly 90% (95% confidence interval, 87.1%-92.3%) of the total 3-month cost associated with AOM and its medical treatment. The cost items of the Otitis Media Diary were also highly correlated with each other and with other measures of clinical and functional health status.Conclusions: Otitis Media Diary measures of parental time and medication use appear to provide a more accurate means of calculating the real social costs attributable to the AOM disease process in this cost-effectiveness analysis.