The Economic Burden of Schizophrenia in the United States in 2013
The Economic Burden of Schizophrenia in the United States in 2013
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DOI：
10.4088/jcp.15m10278
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发表时间：
2016-06-01
影响因子：
5.3
通讯作者：
Wu, Eric
中科院分区：
文献类型：
--
作者：
Cloutier, Martin;Aigbogun, Myrlene Sanon;Wu, Eric
目的：本研究的目的是估计美国精神分裂症的社会经济负担，并更新2002年报告的627亿美元的成本，考虑到过去十年疾病管理和卫生保健结构的变化。方法：采用基于患病率的方法评估与精神分裂症相关的直接医疗成本、直接非医疗成本和间接成本（ICD-9代码295）。Xx)，必要时进行成本调整。直接医疗费用的估算采用回顾性匹配队列设计，使用Truven health Analytics MarketScan商业索赔和遭遇、医疗保险补充和医疗补助多州数据库。估计了执法、无家可归者收容所以及研究和培训的直接非保健费用。间接成本估计为失业造成的生产力损失、就业人员工作效率降低、过早死亡（即自杀）和护理。结果：2013年精神分裂症的经济负担估计为1557亿美元（基于敏感性分析为1344亿- 1743亿美元），其中包括与非精神分裂症个体相比的超额直接医疗成本377亿美元（24%），直接非医疗成本93亿美元（6%）和间接成本1173亿美元（76%）。最大的组成部分是与失业相关的超额成本（38%），由于护理造成的生产力损失（34%）和直接医疗保健成本（24%）。结论：精神分裂症与严重的经济负担有关，其中除了直接医疗费用外，间接和非医疗费用也是主要因素，这表明治疗不仅应着眼于改善症状控制，还应着眼于改善认知和功能表现，这与大量的非医疗和间接费用有关。(C)版权所有2016年医师研究生出版社
Objective: The objective of this study was to estimate the US societal economic burden of schizophrenia and update the 2002 reported costs of $62.7 billion given the disease management and health care structural changes of the last decade.Methods: A prevalence-based approach was used to assess direct health care costs, direct non-health care costs, and indirect costs associated with schizophrenia (ICD-9 codes 295.xx) for 2013, with cost adjustments where necessary. Direct health care costs were estimated using a retrospective matched cohort design using the Truven Health Analytics MarketScan Commercial Claims and Encounters, Medicare Supplemental, and Medicaid Multistate databases. Direct non-health care costs were estimated for law enforcement, homeless shelters, and research and training. Indirect costs were estimated for productivity loss from unemployment, reduced work productivity among the employed, premature mortality (ie, suicide), and caregiving.Results: The economic burden of schizophrenia was estimated at $155.7 billion ($134.4 billion-$174.3 billion based on sensitivity analyses) for 2013 and included excess direct health care costs of $37.7 billion (24%), direct non-health care costs of $9.3 billion (6%), and indirect costs of $117.3 billion (76%) compared to individuals without schizophrenia. The largest components were excess costs associated with unemployment (38%), productivity loss due to caregiving (34%), and direct health care costs (24%).Conclusions: Schizophrenia is associated with a significant economic burden where, in addition to direct health care costs, indirect and non-health care costs are strong contributors, suggesting that therapies should aim at improving not only symptom control but also cognition and functional performance, which are associated with substantial non-health care and indirect costs. (C) Copyright 2016 Physicians Postgraduate Press, Inc.