The cost of illness and economic burden of endometriosis and chronic pelvic pain in Australia: A national online survey
The cost of illness and economic burden of endometriosis and chronic pelvic pain in Australia: A national online survey
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DOI：
10.1371/journal.pone.0223316
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发表时间：
2019-10-10
期刊：
影响因子：
3.7
通讯作者：
Abbott, Jason
中科院分区：
文献类型：
--
作者：
Armour, Mike;Lawson, Kenny;Abbott, Jason
在欧洲、英国和美国，子宫内膜异位症有很大的疾病成本负担，其中大部分成本来自生产力的降低。然而，关于子宫内膜异位症和其他慢性盆腔疼痛原因之间是否存在不同的影响，以及是否存在可修改的因素，如疼痛严重程度，这可能是总体负担的重要贡献者，信息稀缺。方法由SurveyMonkey主办的一项在线调查在2017年2月至4月期间活跃。年龄在18-45岁，目前居住在澳大利亚的女性，要么通过腹腔镜确诊为子宫内膜异位症，要么患有慢性盆腔疼痛，但没有诊断出子宫内膜异位症。WERF EndoCost工具的追溯部分用于确定直接医疗成本、直接非医疗成本(护理人员)和因生产力损失而产生的间接成本。使用已公布的患病率估计将估计外推到澳大利亚人口。结果共收到407份有效回复。对于患有慢性盆腔疼痛的妇女来说，疾病负担的代价是巨大的(每名妇女每年Int$16,970至20,898美元)，无论她们是否被诊断为子宫内膜异位症。大部分成本(75%-84%)是由于生产力损失。澳大利亚的绝对和相对生产率成本都高于之前基于欧洲、英国和美国数据的估计。疼痛评分显示与生产成本的关系最强，从轻微疼痛到重度疼痛的成本增加了12.5倍。在澳大利亚，育龄人口(患病率为10%)每年的总经济负担为65亿印度元。结论与欧洲、英国和美国人口的研究类似，生产力成本是总成本的最大贡献者。由于疼痛是最重要的因素，应该优先考虑改善盆腔疼痛的疼痛控制。
IntroductionEndometriosis has a significant cost of illness burden in Europe, UK and the USA, with the majority of costs coming from reductions in productivity. However, information is scarce on if there is a differing impact between endometriosis and other causes of chronic pelvic pain, and if there are modifiable factors, such as pain severity, that may be significant contributors to the overall burden.MethodsAn online survey was hosted by SurveyMonkey and the link was active between February to April 2017. Women aged 18-45, currently living in Australia, who had either a confirmed diagnosis of endometriosis via laparoscopy or chronic pelvic pain without a diagnosis of endometriosis were included. The retrospective component of the WERF EndoCost tool was used to determine direct healthcare costs, direct non-healthcare costs (carers) and indirect costs due to productivity loss. Estimates were extrapolated to the Australian population using published prevalence estimates.Results407 valid responses were received. The cost of illness burden was significant in women with chronic pelvic pain (Int $16,970 to $ 20,898 per woman per year) irrespective of whether they had a diagnosis of endometriosis. The majority of costs (75-84%) were due to productivity loss. Both absolute and relative productivity costs in Australia were higher than previous estimates based on data from Europe, UK and USA. Pain scores showed the strongest relationship to productivity costs, a 12.5-fold increase in costs between minimal to severe pain. The total economic burden per year in Australia in the reproductive aged population (at 10% prevalence) was 6.50 billion Int $.ConclusionSimilar to studies in European, British and American populations, productivity costs are the greatest contributor to overall costs. Given pain is the most significant contributor, priority should be given to improving pain control in women with pelvic pain