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Cost of Cerebellar Ataxia in Hong Kong: A Retrospective Cost-of-Illness Analysis
Winser John Stanley1, Chan Kit Laam Kelly1, Chinn Ching Tung1
1Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
Insights
The socioeconomic cost of cerebellar ataxia in Hong Kong is substantial, with 6-month costs averaging HKD 146,832. Disease severity significantly correlates with increased direct costs and caregiver expenses.
Area of Science:
- Neurology
- Public Health
- Health Economics
Background:
- Cerebellar ataxia impairs coordination and balance, imposing significant burdens on patients, caregivers, and society.
- The economic impact and disease burden of cerebellar ataxia in Hong Kong remain understudied.
- Understanding these costs is crucial for developing targeted support systems.
Purpose of the Study:
- To estimate the 2019 socioeconomic costs of cerebellar ataxia in Hong Kong.
- To assess patient health-related quality of life (HRQoL) and ataxia severity.
- To correlate ataxia severity with socioeconomic costs and HRQoL.
Main Methods:
- A retrospective cross-sectional study involving 31 cerebellar ataxia patients.
- Data collection via self-reported questionnaires for cost analysis.
- Assessment of ataxia severity using the Scale for Assessment and Rating of Ataxia (SARA) and HRQoL using the SF-36 Health Survey.
Main Results:
- The average 6-month cost per patient was HKD 146,832, comprising HKD 51,371 in direct costs and HKD 93,855 in indirect costs.
- Production loss (42%), caregiver salary (17%), and inpatient care (16%) were major cost drivers.
- Increased disease severity correlated positively with direct costs (Spearman's rho = 0.39) and caregiver costs (Spearman's rho = 0.43).
Conclusions:
- The estimated 6-month socioeconomic cost for cerebellar ataxia patients in Hong Kong is HKD 146,832.
- Disease severity negatively impacts physical functioning and general health (HRQoL).
- Recommendations include enhanced employment support, specialist access, home care, and community integration programs.
Abstract:
Background: Cerebellar ataxia affects the coordination and balance of patients. The impact of this disease increases burden in patients, caregivers and society. Costs and the burden of this disease have not been investigated in Hong Kong. Objectives: (1) To estimate the socioeconomic cost of cerebellar ataxia in Hong Kong for the base year 2019, (2) to assess the health-related quality of life (HRQoL) and severity of ataxia, and (3) to establish the correlation between the severity and cost of cerebellar ataxia and to examine the correlation between the severity of cerebellar ataxia and HRQoL. Methods: A retrospective cross-sectional study was conducted amongst 31 patients with cerebellar ataxia. Cost-related data were obtained through self-reported questionnaires. The severity of ataxia was assessed using the Scale for Assessment and Rating of Ataxia, and HRQoL was assessed using the Short Form (36) Health Survey (SF-36). Pearson correlation was used for normally distributed data, whereas Spearman correlation was used otherwise. Results: The mean severity of ataxia was 21 out of 40. The average direct and indirect costs of a patient with ataxia in 6 months were HKD 51,371 and HKD 93,855, respectively. The mean difference between the independent to minimally dependent in activities of daily living (ADL) group and the moderate to maximally dependent in ADL group for direct and indirect costs was HKD 33,829 and HKD 51,444, respectively. Significant expenditure was related to production lost (42%), caregiver salary (17%), and in-patient care (16%). The physical functioning (r = -0.58) and general health (r = -0.41) of SF-36 were negatively correlated with disease severity (p < 0.05). A significant, positive correlation was found between disease severity and direct cost (Spearman's rho = 0.39) and the cost of hiring a caregiver (Spearman's rho = 0.43). Conclusion: The mean cost for 6 months for patients with cerebellar ataxia in Hong Kong is HKD 146,832. Additional support, including employment, access to specialist consultants, informal home care and community participation, are some areas that should be addressed. Future study on a larger population with a prospective design is necessary to confirm the aforementioned claims.
