The societal cost of bipolar disorder in Sweden
The societal cost of bipolar disorder in Sweden
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DOI：
10.1007/s00127-013-0724-9
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发表时间：
2013-10-01
影响因子：
4.4
通讯作者：
Landen, Mikael
中科院分区：
文献类型：
--
作者：
Ekman, Mattias;Granstrom, Ola;Landen, Mikael
在双相情感障碍中缺乏全面的疾病成本研究，特别是基于患者水平数据的研究。本研究的目的是评估双相情感障碍的社会成本，并将成本与疾病严重程度、抑郁发作、住院和患者功能联系起来。回顾性分析2006-2008年住院和门诊治疗的资源使用数据，以及ICD-10诊断和全球功能评估（GAF）评分，从北方斯德哥尔摩精神病诊所获得，该诊所的集水区包括斯德哥尔摩47%的成年居民。该数据集与处方药和病假的国家登记数据相结合，以估计双相情感障碍的社会成本。该研究从社会角度进行，间接成本根据人力资本方法进行评估。2008年，每位患者的平均年成本为a，而不是28,011（n = 1,846）。病假和提前退休的间接费用占总费用的75%，住院费用占13%，门诊费用占8%，药品占2%，社区护理占2%。对于住院患者（a，无信号55，500 vs. a，无信号22，200）和低GAF评分的患者，情绪发作期间的总成本相当高（比缓解期高6倍）。双相情感障碍的高成本主要由间接成本驱动。费用与情绪发作、住院和低GAF评分密切相关。这表明，降低复发和住院风险并改善功能的治疗可能会降低双相情感障碍的社会成本和患者痛苦。
There is a lack of comprehensive cost-of-illness studies in bipolar disorder, in particular studies based on patient-level data. The purpose of this study was to estimate the societal cost of bipolar disorder and to relate costs to disease severity, depressive episodes, hospitalisation and patient functioning.Retrospective resource use data in inpatient and outpatient care during 2006-2008, as well as ICD-10 diagnoses and Global Assessment of Functioning (GAF) scores, were obtained from the Northern Stockholm psychiatric clinic with a catchment area including 47 % of the adult inhabitants in Stockholm. This dataset was combined with national register data on prescription pharmaceuticals and sick leave to estimate the societal cost of bipolar disorder. The study was conducted from a societal perspective, with indirect costs valued according to the human capital method.The average annual cost per patient was a,not sign28,011 in 2008 (n = 1,846). Indirect costs due to sick leave and early retirement represented 75 %, inpatient costs 13 %, outpatient costs 8 %, pharmaceuticals 2 % and community care another 2 % of the total cost. Total costs were considerably higher during mood episodes (six times higher than in remission), for hospitalised patients (a,not sign55,500 vs. a,not sign22,200) and for patients with low GAF scores.The high cost of bipolar disorder is driven primarily by indirect costs. Costs were strongly associated with mood episodes, hospitalisations and low GAF scores. This suggests that treatment that reduces the risk for relapses and hospitalizations and improve functioning may decrease both the societal cost of bipolar disorder and patient suffering.