摘要
目的:估算2019年大连市抑郁症和双相障碍住院患者的直接成本和间接成本,探索疾病总成本的影响因素。方法:选取大连市第七人民医院抑郁症和双相障碍住院患者共计397例,采用患者自我报告的方式,收集患者过去一年内门诊及住院的医疗花销总费用和自费花销,以及门诊或住院所花费的非医疗费用作为直接成本。采用人力资本法测算患者因病无法工作的劳动损失,结合因病损坏财务的其他损失作为间接成本。成本计算角度为个人水平和社会水平。采用多重线性回归模型对疾病总成本影响因素进行分析。结果:抑郁症和双相障碍住院患者人均疾病总成本在个人水平和社会水平上分别为16681.3元和40733.3元,其中间接费用中的劳动损失占比最高,分别为66.0%和59.0%,且抑郁症患者和双相障碍患者疾病成本构成和数值都存在显著差异。多重线性回归分析结果显示,年龄、性别、工作状态以及疾病严重程度是影响疾病成本的重要因素。结论:抑郁症和双相障碍住院患者经济负担较为沉重,因精神疾病导致的劳动损失是疾病成本的主要组成部分。未来在进行医疗卫生和社会保障资源分配时应向年龄大、男性、无工作且疾病严重程度较重的弱势群体倾斜。
Objective:To estimate the direct and indirect cost of inpatients with major depressive disorder and bipolar disorder in Dalian in 2019,and to explore the drivers to the total costs.Methods:A total of 397 inpatients with major depressive disorder and bipolar disorder were draw from Dalian Seventh People's Hospital.Inpatients?self-report direct outpatient and inpatient medical total and out-of-pocket costs as long as direct non-medical costs were regarded as direct costs.Labor loss calculated by human capital approach and other loss caused by damaging properties were defined as indirect costs.The perspectives of this study included individual and societal levels.Multivariate regression analysis was applied in detecting the factors influencing disease costs.Results:On average,the total costs of major depressive disorder and bipolar disorder inpatients were 16681.3 Yuan at individual level,and 40733.3 Yuan at societal level,among which labor losses account for up to 66.0%and 59.0%at each level respectively.Significant differences of cost distributions were found between inpatients with major depressive disorder and bipolar disorder.Age,gender,working condition and disease severity were the important drivers affect-ing total costs.Conclusion:The economic burden of major depressive disorder and bipolar disorder inpatients is rel-atively high,and the labor loss due to mental disorders is the driving force of the soaring disease cost.The allocation of health and social security resources should be targeted at the most vulnerable groups suffering from mental health problems.
作者
马超
郭琳
黄悦勤
黄劲松
刘肇瑞
张婷婷
许艳秋
多丽丽
魏景明
李芳
贾娜·木海
姜琳
周亮
何燕玲
MA Chao;GUO Lin;HUANG Yueqin;HUANG Jinsong;LIU Zhaorui;ZHANG Tingting;XU Yanqiu;DUO Lili;WEI Jingming;LI Fang;MUHAI Jiana;JIANG Lin;ZHOU Liang;HE Yanling(Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Beijing 100083,China;Dalian Seventh People's Hospital,Dalian 116023,Liaoning Province,China;The Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,China;Shanghai Mental Health Center,Shanghai Jiao Tong Univeisity School of Medicine,Shanghai 200030,China)
出处
《中国心理卫生杂志》
CSCD
北大核心
2021年第12期999-1006,共8页
Chinese Mental Health Journal
基金
国家重点研发计划(2017YFC0907800,2017YFC0907803)。
关键词
抑郁症
双相障碍
直接成本
间接成本
疾病成本研究
major depre sive disorder
bipolar disorder
direct costs
indirect costs
cost-ofilness studies
