The relation between funding by the National Institutes of Health and the burden of disease
The relation between funding by the National Institutes of Health and the burden of disease
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DOI：
10.1056/nejm199906173402406
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发表时间：
1999-06-17
影响因子：
158.5
通讯作者：
Rowe, NR
中科院分区：
文献类型：
--
作者：
Gross, CP;Anderson, GF;Rowe, NR
背景资料。美国医学研究所建议，美国国立卫生研究院(NIH)提供的疾病特异性研究经费数额应与疾病给社会造成的负担进行系统和一致的比较。我们进行了一项横断面研究，将1996年对疾病专项资金的估计与疾病负担的六项衡量标准的数据进行了比较。这些指标是1994年的总死亡率、损失的寿命年数和住院天数，以及1990年的发病率、患病率和伤残调整寿命年(一个伤残调整寿命年的定义是指因疾病失去一年健康生命)。将这些指标作为解释变量进行回归分析，计算出预测经费，并与实际经费进行比较。NIH的经费数额与发病率、患病率或因各种疾病而住院的天数之间没有相关性(分别为P=0.82、P=0.23和P=0.21)。死亡人数(r=0.4，P=0.03)和寿命损失年数(r=0.42，P=0.02)与资助的相关性较弱，而伤残调整的寿命年数对资助有较强的预测性(r=0.62，P<；0.001)。当后三种方法被用来预测预期资助时，对某些疾病资助的适当性的结论因使用的方法不同而不同。然而，无论以哪种标准作为计算支持的基础，获得性免疫缺陷综合征、乳腺癌、糖尿病和痴呆症都得到了相对慷慨的资金。对慢性阻塞性肺疾病、围产期疾病、消化性溃疡的研究相对较少。NIH为一种疾病的研究提供的资金数额与该疾病的负担有关；然而，对疾病负担的不同衡量标准可能会对特定疾病的资助水平的适当性得出不同的结论。(N Engl J Med 1999；340：1881-7)。(C)1999年，马萨诸塞州医学会。
Background. The Institute of Medicine has proposed that the amount of disease-specific research funding provided by the National Institutes of Health (NIH) be systematically and consistently compared with the burden of disease for society.Methods. We performed a cross-sectional study comparing estimates of disease-specific funding in 1996 with data on six measures of the burden of disease. The measures were total mortality, years of life lost, and number of hospital days in 1994 and incidence, prevalence, and disability-adjusted life-years (one disability-adjusted life-year is defined as the loss of one year of healthy life to disease) in 1990. With the use of these measures as explanatory variables in a regression analysis, predicted funding was calculated and compared with actual funding.Results. There was no relation between the amount of NIH funding and the incidence, prevalence, or number of hospital days attributed to each condition or disease (P = 0.82, P = 0.23, and P = 0.21, respectively). The numbers of deaths (r = 0.40, P = 0.03) and years of life lost (r = 0.42, P = 0.02) were weakly associated with funding, whereas the number of disability-adjusted life-years was strongly predictive of fundi ng (r = 0.62, P < 0.001). When the latter th ree measures were used to predict expected funding, the conclusions about the appropriateness of funding for some diseases varied according to the measure used. However, the acquired immunodeficiency syndrome, breast cancer, diabetes mellitus, and dementia all received relatively generous funding, regardless of which measure was used as the basis for calculating support. Research on chronic obstructive pulmonary disease, perinatal conditions, and peptic ulcer was relatively underfunded.Conclusions. The amount of NIH funding for research on a disease is associated with the burden of the disease; however, different measures of the burden of disease may yield different conclusions about the appropriateness of disease-specific funding levels. (N Engl J Med 1999;340:1881-7). (C) 1999, Massachusetts Medical Society.