A comparison of health-care costs involved in treating people with and without Parkinson's disease in Southern Sydney, New South Wales, Australia.

摘要

Twelve community-dwelling subjects with Parkinson's disease (PD) and 12 age-matched healthy controls completed a 3-month diary of health-care utilisation in Sydney, Australia. The mean age for the PD group was 71.3 years (SD 5.9, range 62-82 years) versus 73.2 years (SD 6.7, range 63-83 years) for the control group. The mean disease duration of the PD group was 6.8 years (SD 3.6, range 2-14 years). The median Hoehn and Yahr stage was 3 (range 1-3). The mean 3-month total (both related and 'unrelated' to PD) health-care cost for the PD group was significantly higher than that for the 'healthy' control group (1,755 Australian dollars, SD 1,201 versus 413 Australian dollars, SD 515, P=0.001). Medication was the most costly component for both groups (PD 636 Australian dollars, SD 226 versus controls 175 Australian dollars, SD 233, P<0.001) followed by general practitioner or specialist medical expenses (PD 564 Australian dollars, SD 670 versus controls 205 Australian dollars, SD 397, p=0.12) and allied health-care costs (PD 323 Australian dollars, SD 178 versus controls 21 Australian dollars, SD 43, p<0.001). In the PD subgroup, the health-care costs attributed to PD during the 3-month period were significantly higher than health-care costs 'unrelated' to PD (1,202 Australian dollars, SD 820 versus 553 Australian dollars, SD 591, p=0.03). On subgroup analysis, allied health-care costs (related to PD) achieved statistical significance (304 Australian dollars, SD 180 versus 19 Australian dollars, SD 19, p<0.0001), whereas medication and general practitioner or specialist costs did not. In conclusion, we found that the total direct health-care cost of PD for patients with Hoehn and Yahr stage 3 was four times that of age- and sex-matched 'healthy' controls. The estimated annual cost (7,020 Australian dollars per patient) in our patient cohort was comparable to that reported in the United States and Europe.