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Costs of chronic disease and an alternative to reduce these costs: Case study of end stage renal disease (ESRD)

机译：慢性疾病的成本以及降低这些成本的替代方法：终末期肾脏疾病（ESRD）的案例研究

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摘要

An improved understanding of the costs of diseases is obtained by conducting a case study of the costs associated with end stage renal disease (ESRD). In estimating the costs of ESRD, the costs incurred by both patients and their primary unpaid caregivers are calculated. Most economic studies of the costs of diseases ignore either the patients' or unpaid caregiver side, focusing on one or the other. From a theoretical standpoint, it is shown unpaid caregiving lowers the costs of diseases to society. Unpaid caregiver lowers the cost, because for unpaid caregiving to occur, the net benefits of unpaid caregiving must be lower than the net benefits of hiring a paid caregiver.;Using patients and their primary caregivers at the Gambro Dialysis Center in College Station, Texas as a case study, estimated total ESRD costs range from $84,000 to $121,000/year/case. The distribution of these costs is positively skewed. Of the total costs, approximately 2% to 25% can be attributed to unpaid caregiving. Excluding direct medical costs in total ESRD costs, unpaid caregiving is 14% to 65% of total ESRD costs. Consideration of unpaid caregiving costs is, therefore, an important component of the costs of diseases. These estimates are conservative as the costs associated with lifestyle changes and health effects are noted, but no monetary value is placed on them. Results also indicate the patients' and caregivers' perception of the quantity of caregiving varies.;An alternative water supply system to improve the efficiency of water supply systems taking into account water pricing, marketing, and treatment costs is proposed. This system treats and supplies water differently depending on the source of the water and if the end-use of the water is a potable or non-potable use, then may reduce treatment costs. Decreased treatment costs may make more stringent water standards more affordable. More stringent water standards may cause a decrease in the risk of water-related diseases including ESRD induced by water-borne toxins. Reducing the risk of ESRD will reduce society's costs associated with chronic illnesses. Possible benefits and costs of the proposed system are discussed, but not calculated.
机译：通过对终末期肾病（ESRD）相关成本进行案例研究，可以更好地了解疾病成本。在估算ESRD的费用时，要计算出患者及其主要无偿护理人员的费用。关于疾病成本的大多数经济学研究都忽略了患者或无偿护理人员，而侧重于另一方。从理论上看，无偿护理降低了疾病给社会带来的成本。无偿看护者降低了成本，因为发生无偿看护者时，无偿看护者的净收益必须低于雇用有偿看护者的净收益。在德克萨斯州大学城的甘布罗透析中心使用患者及其主要看护者作为案例研究，估计ESRD的总成本在$ 84,000至$ 121,000 /年/例之间。这些成本的分配存在明显的偏差。在总费用中，约2％至25％的费用可归因于无偿护理。不包括ESRD费用总额中的直接医疗费用，无偿护理费用占ESRD费用总额的14％至65％。因此，考虑未付的护理费用是疾病费用的重要组成部分。这些估计是保守的，因为记录了与生活方式变化和健康影响相关的成本，但没有对货币价值进行评估。结果还表明患者和护理人员对护理数量的看法各不相同。提出了一种替代供水系统，该系统考虑了水价，销售和处理成本，可提高供水系统的效率。该系统根据水的来源来不同地处理和供水，如果水的最终用途是可饮用或不可饮用，则可以降低处理成本。降低的处理成本可以使更严格的水质标准更加可承受。更严格的水标准可能会降低与水有关的疾病（包括由水源毒素诱导的ESRD）的风险。减少ESRD的风险将减少与慢性病相关的社会成本。讨论了所提议系统的可能的收益和成本，但未进行计算。

著录项

  • 作者

    Jang, Won-Ik.;

  • 作者单位

    Texas A&M University.;

  • 授予单位 Texas A&M University.;
  • 学科 Agricultural economics.;Public health.
  • 学位 Ph.D.
  • 年度 2003
  • 页码 183 p.
  • 总页数 183
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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