Cost-of-illness of neck pain in The Netherlands in 1996
Cost-of-illness of neck pain in The Netherlands in 1996
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DOI：
10.1016/s0304-3959(98)00268-1
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发表时间：
1999-04-01
期刊：
影响因子：
7.4
通讯作者：
Bouter, LM
中科院分区：
文献类型：
--
作者：
Borghouts, JAJ;Koes, BW;Bouter, LM
一般人群中颈部疼痛的患病率在 10% 至 15% 之间。这些投诉可能会导致大量的医疗消耗、缺勤和残疾。在这项研究中，我们调查了 1996 年荷兰颈部疼痛的费用，以评估其给社会带来的经济负担。该研究基于患病率数据。数据来源包括国家登记处、研究机构和卫生保健当局的报告，对医院护理、全科护理和辅助医疗护理的直接卫生保健成本进行了估算。这些成本是使用费用计算的。间接成本（缺勤和伤残）的计算基于人力资本法（HCM）。作为替代方法，使用了摩擦成本法 (FCM)。 1996 年荷兰因颈部疼痛造成的总费用估计为 6.86 亿美元。 1996 年，这些费用约占医疗保健总支出的 1% 和国内生产总值 (GDP) 的 0.1%。直接费用为 1.6 亿美元 (23%)。辅助医疗护理在直接成本中所占比例最大（84%）。当应用 HCM 计算间接成本时，这些成本达到 5.27 亿美元（77%）。 1996 年，与颈部疼痛有关的病假总数估计为 140 万天，总费用为 1.854 亿美元。1996 年，颈部疼痛造成的残疾在与颈部疼痛有关的总费用中所占比例最大（50%）（341 美元）。当应用 FCM 计算间接成本时，这些成本减少到 9600 万美元。 1996 年，荷兰因颈部疼痛而付出的代价是巨大的。在解释时应谨慎，因为必须做出许多假设才能估计总成本。本研究中显示的成本结构具有较高的间接成本，这在其他研究中也有发现。从经济角度来看，防止患者请病假和残疾似乎很重要。实现这一目标的方法之一是开发和研究更有效的急性颈部疼痛治疗方法，以防止患者发展为慢性疼痛和残疾。另一种选择是通过精心管理来保护慢性病患者免于病假和残疾。因此，在直接医疗费用领域，通过刺激和提高（辅助）医疗保健的成本效率和成本效益，可能存在节省成本的空间。为了应对具体疾病信息的缺乏，需要更详细的医疗消费、病假和伤残信息，以供未来的成本分析。 (C) 1999 年国际疼痛研究协会。由 Elsevier Science B.V. 出版
The prevalence of neck pain in the general population ranges from 10 to 15%. The complaints can result in substantial medical consumption, absenteeism from work and disability. In this study we investigated the costs of neck pain in the Netherlands in 1996 to assess the financial burden to society. The study was based on prevalence data. Data sources included national registries, reports of research institutes and health care authorities, Direct health care costs were estimated for hospital care, general practice care and paramedical care. These costs were calculated using fees. Calculation of indirect costs (absenteeism and disability) was based on the Human Capital Method (HCM). As an alternative approach the Friction Cost Method (FCM) was used. The total cost of neck pain in The Netherlands in 1996 was estimated to be US $686 million. The share of these costs was about 1% of total health care expenditures and 0.1% of the Gross Domestic Product (GDP) in 1996. Direct costs were $160 million (23%). Paramedical care accounted for largest proportion of direct costs (84%). When applying the HCM for calculating indirect costs, these costs amounted to $527 million (77%). The total number of sick days related to neck pain were estimated to be 1.4 million with a total cost of $185.4 million in 1996. Disability for neck pain accounted for the largest proportion (50%) of the total costs related to neck pain in 1996 ($341). When applying the FCM for calculating the indirect costs, these costs were reduced to $96 million. The costs related to neck pain in 1996 in The Netherlands were substantial. Some caution should be taken in interpretation, as a number of assumptions had to be made in order to estimate the total costs. The cost structure shown in this study, with high indirect costs, has also been found in other studies. From an economical point of view it seems to be important to prevent patients from having to take sick leave and disability. One way in achieving this goal is to develop and investigate more effective treatments for acute neck pain, in order to prevent patients developing chronic pain and disability. Another option is to protect chronic patients from sick leave and disability by careful management. Thus, also in the area of direct medical costs, there may be room for cost savings by stimulating and improving cost-efficiency and cost-effectiveness of the (para)medical care. In order to deal with the lack of specific disease information, more detailed information of medical consumption, sick leave and disability is required for future cost analysis. (C) 1999 International Association for the Study of Pain. Published by Elsevier Science B.V.