中国儿童特应性皮炎的疾病经济负担与医疗资源利用情况

doi:10.5246/jcps.2024.05.035

摘要/Abstract

摘要：

本研究的主要目的是测算中国儿童特应性皮炎患者疾病治疗相关的年均总费用和医疗资源利用率,次要目的是调查与特应性皮炎费用相关的因素。研究采用方便抽样的横断面研究。患者层面的数据来自于2022年2月至3月期间在中国31个省份开展的一项基于互联网的全国性问卷调查。研究招募了经医生确诊为特应性皮炎的18岁以下儿童的照护者, 并收集了所有符合条件的参与者的社会人口学、临床特征、医疗资源利用数据、疾病相关的照护时间和疾病相关的各种成本。共纳入599个符合条件的家庭。82.5%的家庭表示其患儿在过去12个月中至少接受过一次门诊或急诊治疗, 5.8%的家庭表示其患儿在过去1年内曾住院治疗。每个家庭因特应性皮炎而产生的总费用约为28591.92元/年, 其中92.8%为直接成本。门诊或急诊费用的90.7%、住院费用的43.4%为自付费用。中度(coefficient ± SE: 0.22 ± 0.09, P = 0.012)和重度AD患者组(coefficient ± SE: 0.58 ± 0.15, P < 0.001)、AD发病部位在头颈部或手部(coefficient ± SE: 0.57 ± 0.14, P < 0.001)、使用生物制剂(coefficient ± SE: 0.64 ± 0.11, P < 0.001)、使用中医治疗(coefficient ± SE: 0.26 ± 0.09, P = 0.003)与其各自参照组相比, 年总费用更高。因此可以得出,中国儿童特应性皮炎患者的病情严重程度不同, 造成的疾病经济负担也不同。除疾病严重程度外, 儿童特应性皮炎患者可能会因临床因素和治疗方法的不同而产生更高的治疗相关费用。

关键词: 特应性皮炎, 经济负担, 医疗资源利用, 相关因素

Abstract:

The primary objective of this study was to estimate the costs and healthcare resource utilization (HCRU) associated with atopic dermatitis (AD) in Chinese pediatric patients and to investigate the factors contributing to the costs of AD. This cross-sectional study employed a convenience sampling approach, with patient-level data obtained from a nationwide survey conducted across 31 provinces in China between February and March of 2022, utilizing an internet-based questionnaire. Caregivers of children under 18 years old with a physician-confirmed diagnosis of atopic dermatitis were recruited, and sociodemographic information, clinical characteristics, HCRU data, time spent on caregiving, and disease-related costs were collected from all eligible participants. A total of 599 eligible families were included in the study. Among them, 82.5% of families reported that their child had at least one outpatient or emergency room visit, while 5.8% of families reported that their child had been hospitalized in the past 12 months. The average annual cost across all cost categories amounted to 28 591.92 yuan per patient per year (PPPY), with 92.8% attributed to direct costs. Out-of-pocket expenses accounted for 90.7% of the cost of outpatient or emergency room visits and 43.4% of the cost of hospitalization. Factors associated with higher annual total costs included moderate (coefficient ± SE: 0.22 ± 0.09, P = 0.012) and severe AD patient groups (coefficient ± SE: 0.58 ± 0.15, P < 0.001), onset of AD on the head, neck, or hands (coefficient ± SE: 0.57 ± 0.14, P < 0.001), use of biological agents (coefficient ± SE: 0.64 ± 0.11, P < 0.001), and use of traditional Chinese medicine (TCM) (coefficient ± SE: 0.26 ± 0.09, P = 0.003), compared with their respective reference groups. This study highlighted a considerable economic burden of AD among pediatric patients in China across different disease severity groups, with significantly higher costs observed in patients with more severe disease. Additionally, factors such as disease severity, clinical characteristics, and treatment modalities might contribute to the higher costs encountered by pediatric patients with AD.

Key words: Atopic dermatitis, Economic burden, Healthcare resource utilization, Associated factors

Supporting:

聂智峰, 肖若薇, 宋佳芳, 韩晟, 李薇, 朱贺, 史录文. 中国儿童特应性皮炎的疾病经济负担与医疗资源利用情况[J]. 中国药学(英文版), 2024, 33(5): 458-469.

Zhifeng Nie, Ruowei Xiao, Jiafang Song, Sheng Han, Wei Li, He Zhu, Luwen Shi. Economic burden and healthcare resource utilization of childhood atopic dermatitis in China[J]. Journal of Chinese Pharmaceutical Sciences, 2024, 33(5): 458-469.

图/表 5

Table 1. Socio-demographic and clinical profile of children with AD.

Table 2. HCRU for children with AD in the past year.

Table 3. Costs for families of children with AD in the past year.

Table 4. Factors associated with annual total costs using a GLM.

Table 5. Subgroup analyses for annual total costs.

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