Societal cost of rheumatoid arthritis patients in the US
Societal cost of rheumatoid arthritis patients in the US
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DOI：
10.1185/03007990903422307
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发表时间：
2010-01-01
影响因子：
2.3
通讯作者：
Cifaldi, Mary
中科院分区：
文献类型：
--
作者：
Birnbaum, Howard;Pike, Crystal;Cifaldi, Mary
目的：估计类风湿性关节炎（RA）患者的社会和个人利益相关者，包括患者/雇员，雇主，家庭成员/照顾者，和government.Research设计和方法的综合成本：行政索赔数据库，包括私人保险和医疗保险和医疗补助受益人在美国被用来计算超额付款人和支付的费用，每例RA患者与匹配的对照组相比。同样，估计了照顾者和未投保的RA患者的人均额外费用。对其他负担的成本进行了估计，包括雇主失去工作的成本、适应家庭和工作环境的成本、在职生产力的损失、非正式和雇用的护理/家务帮助以及工作更替成本。与生活质量恶化相关的无形成本是根据法律的系统陪审团裁决进行估计的，而过早死亡的成本是根据终身收入数据进行估计的。人均成本估计数按相关人口加权，以估计社会成本。由于数据是不完整的，需要几个假设，这些假设可能会导致过高或过低估计的成本burners.Results：RA患者的年度超额医疗费用为84亿美元，其他RA后果的成本为109亿美元。这些费用相当于每年193亿美元。从利益相关者的角度来看，总成本的33%分配给雇主，28%分配给患者，20%分配给政府，19%分配给护理人员。增加无形成本的生活质量恶化（103亿美元）和过早死亡（96亿美元），RA（直接，间接和无形）的总年度社会成本增加到392亿美元billion.Conclusions：RA在美国的社会成本分别为193亿美元和392亿美元（2005年美元），没有和无形成本。这项研究是第一次尝试量化RA的综合负担。尽管在数据很少的领域做出了一些假设，但研究结果对RA的全部负担产生了有益的见解。
Objective: To estimate comprehensive cost of rheumatoid arthritis (RA) patients to society and individual stakeholders, including patients/employees, employers, family members/caregivers, and government.Research design and methods: Administrative claims databases covering privately insured and Medicare and Medicaid beneficiaries in the US were used to compute the excess payer and beneficiary-paid costs per patient with RA compared with matched controls. Similarly, per-person excess costs for caregivers and uninsured patients with RA were estimated. Costs were estimated for other burdens, including costs of work-loss to employers, adaptations to home and work environments, lost on-the-job productivity, informal and hired care/household help, and job turnover costs. Intangible costs associated with quality-of-life deterioration were estimated based on legal system jury awards, whereas costs for premature mortality were based on lifetime earnings data. Percapita cost estimates were weighted by the relevant population to estimate societal costs. Because data were incomplete, several assumptions were required; these assumptions could lead to an over- or under-estimation of cost burdens.Results: Annual excess health care costs of RA patients were $8.4 billion, and costs of other RA consequences were $10.9 billion. These costs translate to a total annual cost of $19.3 billion. From a stakeholder perspective, 33% of the total cost was allocated to employers, 28% to patients, 20% to the government, and 19% to caregivers. Adding intangible costs of quality-of-life deterioration ($10.3 billion) and premature mortality ($9.6 billion), total annual societal costs of RA (direct, indirect, and intangible) increased to $39.2 billion.Conclusions: Societal costs of RA in the US are $19.3 billion and $39.2 billion (in 2005 dollars) without and with intangible costs, respectively. This study was one of the first to attempt to quantify the comprehensive burdens of RA. Despite several assumptions made in areas in which few data exist, the findings generate useful insights into the full burden of RA.