中国银行业员工偏头痛的医疗利用率和经济负担:一项概率模型研究

Du Wei, Li Ping Wong, Xun He, Tharani Loganathan
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引用次数: 0

摘要

尽管偏头痛在银行职员中的发病率很高,但他们的医疗保健使用模式和偏头痛的经济负担仍未得到充分研究。研究中国银行员工中与偏头痛相关的医疗使用情况,并估算偏头痛的经济负担。我们于 2022 年 5 月至 10 月在中国贵州省开展了一项横断面调查。HARDSHIP调查问卷用于识别偏头痛阳性个体,并询问他们的医疗使用情况和生产力损失。采用微观成本计算的概率决策分析模型,从医疗系统、雇主和社会的角度估算经济负担。所有成本均以 2022 美元表示。进行了单向和概率敏感性分析。近一半的偏头痛患者表示没有就医。只有21.8%的偏头痛患者在门诊就诊,52.5%的偏头痛患者服用药物,27.1%的偏头痛患者使用辅助疗法。慢性偏头痛患者的医疗保健使用率明显高于偶发性偏头痛患者。在每月偏头痛发作频率达到或超过15天的患者中,63.6%的人采取了不恰当的治疗方法,过度使用急性药物。贵州银行业偏头痛患者每年给医疗系统造成的损失中位数为757.80万美元(第25至75百分位数为450.92-1643.49万美元),给雇主造成的损失中位数为8975.03万美元(第25至75百分位数为5321.16-15116.22万美元),给社会造成的损失中位数为10885.03万美元(第25至75百分位数为6737.01-18104.86万美元)。每位患者每年的社会成本中位数为 3,078.1 美元。偏头痛发病率和生产力损失被认为是成本的主要驱动因素。研究指出,有必要提高所有利益相关者对偏头痛的认识,并改善偏头痛治疗系统的组织结构。研究强调了偏头痛对医疗系统、雇主和整个社会造成的巨大经济负担。这些成本估算为评估改善偏头痛管理所带来的经济节约提供了基于证据的基准,同时也能引起中国政策制定者的注意,将偏头痛政策作为银行业和其他以办公室为基础的职业的优先政策。
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Healthcare utilisation and economic burden of migraines among bank employees in China: a probabilistic modelling study
Despite the recognised high prevalence of migraines among bank employees, yet their healthcare utilisation patterns and the economic burden of migraines remain underexplored. To examine migraine-related healthcare utilisation among bank employees in China, and to estimate the economic burden of migraines. A cross-sectional survey was conducted in Guizhou province, China between May and October 2022. The HARDSHIP questionnaire was used to identify migraine-positive individuals and enquire about their healthcare utilisation and productivity losses. A probabilistic decision-analytic model with a micro-costing approach was used to estimate the economic burden from the perspectives of the healthcare system, employers, and society. All costs were expressed in 2022 United States dollars. One-way and probabilistic sensitivity analyses were performed. Nearly half of individuals with migraines reported not seeking medical care. Only 21.8% reported seeking outpatient consultations, 52.5% reported taking medicines, and 27.1% reported using complementary therapies. Chronic migraine patients had significantly higher healthcare utilisation than episodic migraine patients. Among individuals with a monthly migraine frequency of 15 days or more, 63.6% took inappropriate treatments by excessively using acute medications. Migraines in the banking sector in Guizhou cost the healthcare system a median of $7,578.0 thousand (25th to 75th percentile $4,509.2–$16,434.9 thousand) per year, employers $89,750.3 thousand (25th to 75th percentile $53,211.6–$151,162.2 thousand), and society $108,850.3 thousand (25th to 75th percentile $67,370.1–$181,048.6 thousand). The median societal cost per patient-year is $3,078.1. Migraine prevalence and productivity losses were identified as key cost drivers. The study points to the need to raise awareness of migraines across all stakeholders and to improve the organisation of the migraine care system. A substantial economic burden of migraines on the healthcare system, employers, and society at large was highlighted. These cost estimates offer evidence-based benchmarks for assessing economic savings from improved migraine management, and can also draw the attention of Chinese policymakers to prioritise migraine policies within the banking and other office-based occupations.
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