Economic burden of stroke in a rural South African setting.
Economic burden of stroke in a rural South African setting.
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DOI：
10.1016/j.ensci.2016.01.001
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发表时间：
2016-06-01
期刊：
影响因子：
--
通讯作者：
Chola L
中科院分区：
文献类型：
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作者：
Maredza M;Chola L
中风是南非第二大死亡原因和主要残疾原因，但缺乏关于中风经济成本的公开数据，特别是在农村地区。我们使用基于患病率的自下而上的成本计算方法，从卫生系统的角度估计了2012年卒中的总直接成本。直接费用包括诊断、住院和门诊护理。分析依据的是阿金库尔卫生和社会人口监测系统，该系统覆盖约90 000人。使用了SASPI研究、Tintswalo医院卒中登记和国家成本数据库的已发表数据。进行敏感性分析以解释所用数据的变异性。2012年，中风的直接总成本估计为250 - 420万兰特（283，500 - 485，000美元），占分区卫生支出的1.6%-3%。其中80%是住院费用。总成本是最敏感的基本发病率和服务利用率的假设。我们的研究提供了南非农村中风费用的快照。我们表明，中风是一种具有高经济成本的疾病。需要进一步研究评估中风的终生成本，以更好地了解在疾病的不同阶段进行干预所节省的费用。我们提出的第一个估计费用治疗中风在南非农村。在这种情况下，中风造成了很高的经济负担。直接费用总额为283，500至485，000美元，占分区卫生支出的1.6%至3%。中风的疾病成本研究可以利用现有的信息来源进行。
Stroke is the second leading cause of mortality and leading cause of disability in South Africa yet published data on the economic costs of stroke is lacking particularly in rural settings. We estimate the total direct costs of stroke in 2012 from a health system perspective using a prevalence-based, bottom-up costing approach. Direct costs include diagnosis, inpatient and outpatient care. Analysis is based on the Agincourt health and socio-demographic surveillance system, which covers approximately 90,000 people. Published data from the SASPI study, Tintswalo Hospital Stroke register, and national cost databases were used. Sensitivity analysis was carried out to account for the variability in the data used. The total direct costs of stroke were estimated to be R2.5–R4.2 million (US$283,500–US$485,000) in 2012 or 1.6–3% of the sub-district health expenditure. Of this, 80% was attributed to inpatient costs. Total costs were most sensitive to the underlying incidence rates and to assumptions regarding service utilisation. Our study provides a snapshot of costs incurred on stroke in rural South Africa. We show that stroke is a disease with high economic costs. Further studies that assess the lifetime costs of stroke are needed to better understand savings accrued from intervening at different stages of the disease. We present the first estimates of costs of treating stroke in rural South Africa. Stroke imposes a high economic burden in this setting. Total direct costs of US$283,500 –US$485,000 represent 1.6-3% of the sub-district health expenditure. Cost-of-illness studies for stroke can be conducted using available information sources.