Estimating the lifetime economic burden of stroke according to the age of onset in South Korea: a cost of illness study.
Estimating the lifetime economic burden of stroke according to the age of onset in South Korea: a cost of illness study.
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DOI：
10.1186/1471-2458-11-646
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发表时间：
2011-08-13
影响因子：
4.5
通讯作者：
Liew D
中科院分区：
文献类型：
--
作者：
Kang HY;Lim SJ;Suh HS;Liew D
最近观察到的韩国中风患者年轻化的趋势引发了经济方面的担忧，包括劳动力的流失。我们从韩国社会的角度比较了中风发病年龄的人均终生费用。建立了由三种健康状态(“卒中后事件”、“卒中后存活”和“死亡”)组成的状态转移马尔可夫模型，以模拟卒中的自然历史。按年龄和性别分列的致命性和非致命性复发性中风和非中风死亡原因的转移概率是根据韩国健康保险审查和评估服务的国家流行病学数据和丹麦心血管疾病监测趋势研究的数据得出的。我们使用一种基于发病率的方法来估计中风的长期成本。该模型涵盖了与中风相关的成本，包括卫生部门内的成本、患者在卫生部门外的自付成本，以及使用人力资本方法因发病率和过早死亡而造成的生产力损失造成的成本。从国家健康保险索赔数据库中估计了卫生部门发生的平均保险覆盖费用。其他费用是根据国家流行病学数据和文献估算的。所有成本均以2008年韩元价值(韩元=韩元)列示。中风的终生成本估计为：45岁、55岁和65岁首次中风的男性分别为200.7、81.9和1640万韩元(1,200韩元约相当于1美元)，相同年龄的女性分别为7570万、3920万和1930万韩元。虽然45岁至年龄段的韩国人中发生的中风只占总发病率的30%，但这个年龄段的人却承担了全国中风终生总成本的75%。韩国年轻人一生负担更重，中风发病率不断增加，这突出表明需要采取更有效的战略来预防和管理中风，特别是40至60岁的人群。
The recently-observed trend towards younger stroke patients in Korea raises economic concerns, including erosion of the workforce. We compared per-person lifetime costs of stroke according to the age of stroke onset from the Korean societal perspective. A state-transition Markov model consisted of three health states ('post primary stroke event', 'alive post stroke', and 'dead') was developed to simulate the natural history of stroke. The transition probabilities for fatal and non-fatal recurrent stroke by age and gender and for non-stroke causes of death were derived from the national epidemiologic data of the Korean Health Insurance Review and Assessment Services and data from the Danish Monitoring Trends in Cardiovascular Disease study. We used an incidence-based approach to estimate the long-term costs of stroke. The model captured stroke-related costs including costs within the health sector, patients' out-of-pocket costs outside the health sector, and costs resulting from loss of productivity due to morbidity and premature death using a human capital approach. Average insurance-covered costs occurring within the health sector were estimated from the National Health Insurance claims database. Other costs were estimated based on the national epidemiologic data and literature. All costs are presented in 2008 Korean currency values (Korean won = KRW). The lifetime costs of stroke were estimated to be: 200.7, 81.9, and 16.4 million Korean won (1,200 KRW is approximately equal to one US dollar) for men who suffered a first stroke at age 45, 55 and 65 years, respectively, and 75.7, 39.2, and 19.3 million KRW for women at the same age. While stroke occurring among Koreans aged 45 to 64 years accounted for only 30% of the total disease incidence, this age group incurred 75% of the total national lifetime costs of stroke. A higher lifetime burden and increasing incidence of stroke among younger Koreans highlight the need for more effective strategies for the prevention and management of stroke especially for people between 40 and 60 years of ages.
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