文章摘要
仇桑桑,陆 慧,张思慜,姜 伟,黄莉芳,王建明.结核病患者疾病经济负担比较研究[J].南京医科大学学报(社会科学版),2014,(5):354~358
结核病患者疾病经济负担比较研究
Comparative study on the economic burden of patients with tuberculosis
投稿时间:2014-07-27  
DOI:doi:10.7655/NYDXBSS20140503
中文关键词: 结核  疾病负担  直接费用  间接费用  危险因素
英文关键词: tuberculosis  disease burden  direct cost  indirect cost  risk factor
基金项目:国家自然科学基金(81072351);江苏省科技支撑计划 (BE2011841);江苏高校哲学社会科学研究基金(2014SJB164)
作者单位
仇桑桑 南京医科大学公共卫生学院流行病与卫生统计学系,江苏 南京 211166 
陆 慧 南京医科大学公共卫生学院社会医学与健康教育学系,江苏 南京 211166 
张思慜 南京医科大学公共卫生学院流行病与卫生统计学系,江苏 南京 211166 
姜 伟 张家港市疾病预防控制中心结核科,江苏 张家港 215600 
黄莉芳 张家港市疾病预防控制中心结核科,江苏 张家港 215600 
王建明 南京医科大学公共卫生学院流行病与卫生统计学系,社会医学与健康教育学系,江苏 南京 211166 
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中文摘要:
      目的: 了解经济发展水平不同地区结核病患者疾病经济负担及其影响因素?方法: 以江苏省张家港市和泰兴市为研究现场,以2010~2013年完成规定抗结核疗程的肺结核病患者为研究对象,收集并比较患者因病支付的直接费用和间接费用?结果:共590例患者完成调查,其中张家港274例,总支出费用人均18 793.3元,中位数9 965.0元;泰兴316例,总支出费用人均6 598.3元,中位数2 263.0元,两地支出费用差异有统计学意义(Z=10.42,P < 0.001)?张家港市患者人均自付直接费用7 448.0元,人均间接费用6 856.4元?泰兴市患者人均自付直接费用3 024.0元,人均间接费用2 615.2元?张家港市影响直接自付费用的因素包括流动人口?诊断延误?住院治疗?服用保肝药?使用二线药物等?泰兴市影响直接自付费用的因素有药物不良反应?肝功能异常?诊断延误?住院治疗?服用保肝药?使用二线药物等?结论:虽然政府实施结核病免费诊疗策略,患者仍需承担较高的自付费用,经济发达地区患者的疾病经济负担更高?
英文摘要:
      Objective:To analyze the economic burden of tuberculosis patients in areas with different economic levels, and to explore factors related to their economic burden. Methods: Two counties from Jiangsu Province, Zhangjiagang and Taixing, were selected as the study sites. Tuberculosis patients who had already completed the standard anti-tuberculosis treatment from 2010 to 2013 were recruited as the study subjects. Direct and indirect costs due to the disease were collected and compared between these two areas. Results: A total of 590 patients who had completed the survey were involved in the analysis, including 274 cases from Zhangjiagang and 316 cases from Taixing. The average total costs were 18 793.3 (median: 9 965.0) CNY for patients in Zhangjiagang and 6 598.3 (median: 2 263.0) CNY for patients in Taixing, respectively. The difference of costs between these two areas was significant (Z = 10.42, P < 0.001). In Zhangjiagang, the per capita out-of-pocket direct cost was 7 448.0 CNY and the per capita indirect cost was 6 856.4 CNY. In Taixing, the per capita out-of-pocket direct cost was 3 024.0 CNY and the per capita indirect cost was 2 615.2 CNY. Factors related to the out-of-pocket direct costs were migrant population, diagnosis delay, hospitalization, taking liver protective drugs and using the second-line drugs in Zhangjiagang, etc, and adverse drug reactions, abnormal liver function, diagnosis delay, hospitalization, taking liver protective drugs and using the second-line drugs, etc, in Taixing. Conclusion: Although the government provides free-service policy for tuberculosis, patients still need to bear a high economic burden, especially in economically developed areas.
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