未经证实:精神分裂症是所有精神障碍中每位患者的社会成本中位数最高的。这篇综述总结了10个国家与精神分裂症相关的不同成本/成本驱动因素(成本构成),包括所有成本类型和利益相关者观点,并强调了与最大成本相关的疾病方面。
UNASSIGNED:基于对美国(US)2006-2021年发表的研究的搜索,进行了针对性的文献综述,英国(UK),法国,德国,意大利,西班牙,加拿大,Japan,巴西,和中国。
UNASSIGNED:纳入了64篇已发表的文章(主要研究和文献综述)。有关于精神分裂症总体成本的全面数据,除了美国,个别国家的数据非常有限。大多数数据与直接成本而非间接成本有关,由于几个关键成本组成部分的数据极其稀缺(不良事件,自杀,长期护理)。每人每年与精神分裂症相关的总费用(PPPY)为2,004-94,229美元,各国之间差异很大。间接成本是主要的成本动因(占所有成本的50-90%),从1,852美元到62,431美元不等。然而,间接成本没有系统地收集或纳入卫生技术评估。与精神分裂症相关的PPPY直接费用总额为4,394-31,798美元,住院费用为主要费用动因(约占直接费用的20-99%)。无形成本没有报告。尽管证据有限,有阴性症状的患者与精神分裂症相关的总费用高于无阴性症状的患者,主要是由于药物和医疗费用的增加。
未经评估:由于这不是系统的评估,研究的优先顺序可能导致排除潜在相关数据。所有成本都转换为美元,但未根据通货膨胀进行更正或受到国内生产总值平减指数的影响。
未经评估:直接成本最常见于精神分裂症。间接和无形成本的大量少报低估了支付者精神分裂症的真正经济负担,病人,和社会视角。
精神分裂症等疾病的真实成本远远超出了住院的直接成本,门诊预约和药物治疗,以包括间接成本,例如由于失业而导致的患者和护理人员的生产力损失,提前退休和过早死亡。对2006年至2021年之间发表的文献的回顾表明,精神分裂症的间接成本实际上占所有成本的50%至90%。但在医疗规划中往往没有考虑到。此外,无形成本,包括疼痛,痛苦,压力,患者和护理人员因精神分裂症而经历的焦虑尚未在文献中报道。精神分裂症阴性症状患者的费用也较高(患者出现退缩和缺乏情绪,几乎没有社会关系)与具有阳性症状(包括妄想或幻觉)的人相比。这主要是由于阴性症状患者的药物治疗和医疗费用增加。总之,这篇综述证明了精神分裂症的真实成本,包括直接,间接,和无形成本,可能大大高于目前报告的疾病费用值。
UNASSIGNED: Schizophrenia has the highest median societal cost per patient of all mental disorders. This
review summarizes the different costs/cost drivers (cost components) associated with schizophrenia in 10 countries, including all cost types and stakeholder perspectives, and highlights aspects of disease associated with greatest costs.
UNASSIGNED: Targeted literature
review based on a search of published research from 2006 to 2021 in the United States (US), United Kingdom (UK), France, Germany, Italy, Spain, Canada, Japan, Brazil, and China.
UNASSIGNED: Sixty-four published articles (primary studies and literature reviews) were included. Comprehensive data were available on costs in schizophrenia overall, with very limited data for individual countries except the US. Most data is related to direct and not indirect costs, with extremely scarce data for several key cost components (adverse events, suicide, long-term care). Total schizophrenia-related per person per year (PPPY) costs were $2,004-94,229, with considerable variability among countries. Indirect costs were the main cost driver (50-90% of all costs), ranging from $1,852 to $62,431 PPPY. However, indirect costs are not collected systematically or incorporated in health technology assessments. Total schizophrenia-related PPPY direct costs were $4,394-31,798, with inpatient cost as the main cost driver (∼20-99% of direct costs). Intangible costs were not reported. Despite limited evidence, total schizophrenia-related costs were higher in patients with than without negative symptoms, largely due to increased costs of medication and medical visits.
UNASSIGNED: As this was not a systematic
review, prioritization of studies may have resulted in exclusion of potentially relevant data. All costs were converted to USD but not corrected for inflation or subjected to a gross domestic product deflator.
UNASSIGNED: Direct costs are most commonly reported in schizophrenia. The substantial underreporting of indirect and intangible costs undervalues the true economic burden of schizophrenia from a payer, patient, and societal perspective.
The true costs of diseases such as schizophrenia extend far beyond the obvious direct costs of hospital visits, outpatient appointments and medications to include indirect costs such as loss of productivity among patients and caregivers due to unemployment, early retirement and premature death. This
review of literature published between 2006 and 2021 reveals that the indirect costs of schizophrenia actually account for between 50% and 90% of all costs, but are often not taken into account in healthcare planning. In addition, intangible costs, including the pain, suffering, stress, and anxiety experienced by patients and caregivers due to schizophrenia have not been reported in the literature. Costs were also higher for patients with negative symptoms of schizophrenia (where patients appear withdrawn and lacking in emotion, with few social relationships) compared with those with positive symptoms (including delusions or hallucinations). This is largely due to the greater costs for medications and medical visits among patients with negative symptoms. In summary, this
review demonstrates that the true cost of schizophrenia, including direct, indirect, and intangible costs, is likely to be substantially higher than the values for the cost of disease currently reported.