背景:恰加斯病(CD)是一种被忽视的疾病,影响全球数百万人,然而,人们对它的经济负担知之甚少。这次系统审查是RAISE项目的一部分,一项旨在估计全球患病率的更广泛的研究,死亡率,以及可归因于慢性CD和慢性Chagas心肌病的健康和经济负担。这项研究的目的是评估地方和非地方国家与CD治疗相关的主要费用。
方法:Medline的电子搜索,丁香花,Embase数据库一直进行到31日,2022年,确定和选择评估CD治疗成本的经济研究。没有限制地点或语言。包括完整或部分经济分析。
结果:纳入了15项研究,其中三分之二是指流行国家。最常调查的成本组成部分是住院护理,考试,手术,协商,毒品,和起搏器。然而,观察到估计方法和数据表示的显著异质性,强调测量方法和成本构成缺乏标准化。使用相同指标分析的最常见成分是住院。每位患者的平均年住院费用范围从25.47美元的购买力平价美元(PPP-USD)到18,823.74美元的PPP-USD,中位数为324.44美元购买力平价-美元。每位患者的终生住院费用从一般护理的209,44PPP-USD到心力衰竭患者的14,351.68PPP-USD不等。
结论:尽管纳入的研究存在局限性,本研究是对CD治疗费用的首次系统评价.调查结果强调了标准化测量方法和成本组成部分对于估计CD的经济负担以及提高成本组成部分大小和成本构成分析的可比性的重要性。最后,评估经济负担对于旨在消除CD的公共政策至关重要,考虑到对这种疾病的持续忽视。
BACKGROUND: Chagas disease (CD) is a neglected disease affecting millions worldwide, yet little is known about its economic burden. This systematic
review is part of RAISE project, a broader study that aims to estimate the global prevalence, mortality, and health and economic burden attributable to chronic CD and Chronic Chagas cardiomyopathy. The objective of this study was to assess the main costs associated with the treatment of CD in both endemic and non-endemic countries.
METHODS: An electronic search of the Medline, Lilacs, and Embase databases was conducted until 31st, 2022, to identify and select economic studies that evaluated treatment costs of CD. No restrictions on place or language were made. Complete or partial economic analyses were included.
RESULTS: Fifteen studies were included, with two-thirds referring to endemic countries. The most commonly investigated cost components were inpatient care, exams, surgeries, consultation, drugs, and pacemakers. However, significant heterogeneity in the estimation methods and presentation of data was observed, highlighting the absence of standardization in the measurement methods and cost components. The most common component analyzed using the same metric was hospitalization. The mean annual hospital cost per patient ranges from $25.47 purchasing power parity US dollars (PPP-USD) to $18,823.74 PPP-USD, and the median value was $324.44 PPP-USD. The lifetime hospital cost per patient varies from $209,44 PPP-USD for general care to $14,351.68 PPP-USD for patients with heart failure.
CONCLUSIONS: Despite the limitations of the included studies, this study is the first systematic
review of the costs of CD treatment. The findings underscore the importance of standardizing the measurement methods and cost components for estimating the economic burden of CD and improving the comparability of cost components magnitude and cost composition analysis. Finally, assessing the economic burden is essential for public policies designed to eliminate CD, given the continued neglect of this disease.