Research On The Economic Burden Of Alzheimer's Disease And Its Main Responsibility

[Objective]Investigated the economic burden of Alzheimer's disease,and constructed a model to study the full economic burden of Alzheimer's disease from three aspects:direct economic burden,indirect economic burden,and intangible economic burden.At the same time,based on rich qualitative research,through interviewed with 171 long-term caregivers of Alzheimer's disease,a total of 612,000 words of interview recordings and interview records were sorted out to set up the theoretical structure of the intangible economic burden of Alzheimer's caregivers.To constructed a multi-disciplinary framework for the economic burden of Alzheimer's disease,and to define the responsibilities of the country,the family,and the market according to the results of the calculation and the needs analysised from the caregivers,so as to reduce the economic burden of the Alzheimer's disease family,and provide responsibility for reference and decision supported for the multiple subj ects of related diseases.[Methods]It mainly used questionnaires,in-depth interviews,"Zarit Caregiver Burden Scale" caregiver psychological burden scale survey and grounded theoretical analysis.Investigated the direct,indirect,and intangible economic burden of Alzheimer's disease through a self-designed disease economic burden questionnaire,based on the characteristics of Alzheimer's disease patients include the burden of loss.Through the preparation of the semi-structured interview outline,the subjects were interviewed by telephone interviews and face-to-face interviews,and the in-depth economic burden of the caregiver was analyzed in depth.The internationally-used "Zarit Caregiver Burden Scale" scale was used to compare the psychological burden of the subjects.The interview recordings were compiled into textual materials,and the collected data were encoded and analyzed using MAXqda software.The rooted theory of qualitative research was used to classify the coding integration into a theoretical structural framework.Through the expert consultation platform set up by the subj ect,a questionnaire survey was conducted among experts in the field of prevention and treatment of Alzheimer's disease to study the care mode suitable for patients with Alzheimer's disease and actively adopt the reasonable opinions of experts.Used Microsoft office excel and SPSS22.0 to statistically describe the economic burden data in a centralized and discrete trend,and process the abnormal data to ensure that the analysis results were scientific,accurate and effective.At the same time,used multiple linear regression analysis,tried to construct a mathematical model of social characteristics and the economic burden of Alzheimer's disease and the psychological burden of caregivers.[Results]The average economic burden of the patients in the survey in the past year was 214,969.82 yuan,of which the direct economic burden was 50,459.78 yuan,accounting for 23.47%of the total disease economic burden;the indirect economic burden was 41,380.29 yuan,accounting for 19.25%of the total disease economic burden;The average intangible economic burden was 123,129.75 yuan,accounting for 57.28%of the total disease economic burden.Multivariate stepwise regression analysis showed the monthly income of the caregiver,the level of the disease,the occupational category of the patient,whether the caregiver had retired,the number of patients lost,the relationship between the caregiver and the patient,the age of the caregiver were the seven major influencing factors of the economic burden of disease.In the study of Alzheimer's disease loss,it was found that Alzheimer's disease was the most important cause of the loss of the elderly population aged 60 and over 60.Alzheimer's disease patients accounts for 29.65%of the elderly.By calculated the estimated annual economic burden of the loss of Alzheimer's disease in China,the amount of indirect economic burden was 4,564.45 yuan,but the number of effective searchers that can be estimated was only the number of households looking for,but from the 564 who had been found.It can be seen from the statistics of the elderly that 101 people were found by their families and relatives,accounting for only 17.91%.Only 4.61%of them can go home by themselves.In addition to the family's search after the patient's loss,there were a lot of other manpower,the data showed that nearly 77.48%of the lost elderly needed to be helped by other people,police and so on,before they can finally go home.It can be seen that the indirect economic burden brought by Alzheimer's disease patients to the whole society is much higher than the current forecast,and the loss of Alzheimer's disease patients will also bring a heavy mental and psychological burden to the family.The intangible economic burden caused is difficult to estimate.Focused on the research problem of "invisible economic burden of caregivers",after the integral coding of the intangible economic burden of the comparators,the different sub-categories were summarized through step-by-step refinement,and further integration analysis leads to "natural attribute burden,society attribute burden"two generic categories of attribute burdens,and five sub-categories of "physiological burden,psychological burden,social participation burden,interpersonal relationship burden,and social interaction burden",which ultimately constituted the theoretical structural framework of the invisible economic burden of caregivers.The related research results of the psychological burden of the comparators showed that 11.11%of the caregivers were in a severe burden;54.39%of the caregivers were in a moderate to severe burden;26.90%of the caregivers were in a mild to moderate burden;7.60%of the caregiver wers in a state of little or no burden.From the gender point of view,the average female care burden was 44.75 points,which was higher than the male 44.45 points.Stepwise linear regression analysis found that the patient's loss,the current personal monthly income of the caregiver,were the most influential factors of the burden of the comparison material,in which the patient's loss was positively correlated,and the caregiver's current personal monthly income was negatively correlated.This study constructed a multi-functional framework for the economic burden of Alzheimer's disease,defined the government's direct and indirect responsibilities,the family's pension security responsibilities,basic life care responsibilities and mental and emotional comfort responsibilities,the market's complementary responsibilities and replenishment responsibilities.This provided a theoretical framework for reducing the economic burden of disease in Alzheimer's patients and caregivers.[Conclusion]The annual economic burden of Alzheimer's caregivers were about 214,969.82 yuan,of which the direct economic burden accounted for 23.47%,the indirect economic burden accounted for 19.25%,and the intangible economic burden accounted for 57.28%.The caregivers were suffering from a huge disease economic burden.The economic burden of disease caused by the loss of Alzheimer's disease patients cannot be ignored.The loss of Alzheimer's disease patients will not only cause a certain indirect economic burden on families,but also lead to a heavy mental and psychological burden.Through in-depth qualitative analysised of the intangible economic burden of the comparators,this study found that the caregivers had serious effects on various dimensions of body and mind,including physiological burden,psychological burden,social participation burden,interpersonal relationship burden,social interaction burden,65.50%of the caregivers'ZBI psychological burden scale scores were moderate and above.In the theoretical construction of the economic burden of Alzheimer's disease,the main burden of the economic burden of Alzheimer's disease was mainly the patient's family,but the family's ability and responsibilities were limited.The responsible party cannot be separated from the state,the family,and the market,and all three parties should assume corresponding responsibilities.In the current background of aging,the reduction of the birth rate had greatly reduced the old-age function that the family can provide was limited.The problem of old-age care can not solved only by the family,diversified commitment system will make resource utilization more efficient.The family's responsibilities in the pension model were limited,recognizing the limited responsibilities of family responsibilities,preventing the absence of government and the offside,effectively exerting market mechanisms to make up for the difference,clarifying the scope of duties of multiple subjects,and gradually alleviating the economic burden of patient's family,so that the family can play it's irresistible emotional and emotional comfort in the care of patients with Alzheimer's disease.Find a reasonable division of responsibilities between the country,family,and market of the economic burden of Alzheimer's disease,so as to determine the responsibilities of the parties.