Measuring economic consequences of preterm birth - Methodological recommendations for the evaluation of personal burden on children and their caregivers.
Measuring economic consequences of preterm birth - Methodological recommendations for the evaluation of personal burden on children and their caregivers.
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DOI：
10.1186/2191-1991-1-6
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发表时间：
2011-07-20
影响因子：
2.4
通讯作者：
Mittendorf T
中科院分区：
文献类型：
--
作者：
Hodek JM;von der Schulenburg JM;Mittendorf T
本研究旨在从家庭角度探讨早产对经济和情感负担的影响。此外，还拟订了一份全面的建议时间表，以便充分评价负担的所有方面。基于文献检索的结果，确定了涵盖相关经济和情感负担多个方面的问卷的相关类别和子域，并将其转换为推荐方案。文献检索的结果表明，早产负担对父母的影响很大。除了医疗问题和健康保险系统的进一步财务成本外，这还导致了大量的自付支出（OOPE）和父母的情绪困扰。从婴儿健康状况的结果来看，随着胎龄的降低，OOPE和情绪困扰显著增加。运输的OOPE通常是主要的母成本维度。此外，有一些证据表明收入减少和工作天数减少的程度很高。在从社会角度计算早产的总成本时，必须考虑到家庭的观点。然而，近年来在这一领域进行的经济评价相当不均匀。在未来的研究中，a)直接医疗成本，b)直接非医疗成本，c)间接成本以及d)无形成本（就照顾者和儿童的情绪困扰和生活质量降低而言）是应该评估的主要类别，以充分衡量早产对家庭的个人负担。给出了具体子域的详细列表。此外，这些建议并不局限于早产儿和/或低出生体重婴儿的应用。
This study aims to identify the impact of a preterm birth on financial and emotional burden from the families' perspective. Additionally, a comprehensive schedule of recommendations for a sufficient evaluation of all aspects of burden is developed. Based on the results of a literature search relevant categories and sub-domains for a questionnaire covering multiple aspects of associated financial and emotional burden are identified and converted into a recommendation scheme. Results of the literature search illustrate the large extend of burden of prematurity on parents. This results in substantial out-of-pocket expenditures (OOPE) and emotional distress to the parents besides the medical problems and further financial costs to the health insurance system. According to the results on infants' state of health, OOPE and emotional distress are significantly increased with decreasing gestational age. OOPE for transportation often amounts to the main parental cost dimension. Moreover there is some evidence for a high magnitude of reduced income and missed work days. The family perspective has to be taken into account when calculating the overall costs of preterm births from a societal point of view. However, in recent years economic evaluations were performed rather inhomogeneously in this field. For future studies a) direct medical costs, b) direct non-medical costs, c) indirect costs as well as d) intangible costs (in terms of emotional distress and reduced quality of life for caregivers and children) are the main categories that should be evaluated measuring personal burden of preterm birth on families adequately. A detailed list of specific sub-domains is given. Additionally, the recommendations are not restricted to application in infants born preterm and/or at low birth weight.