中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2010年
12期
1340-1345
,共6页
梁森%张顺祥%马起山%肖和卫%吕秋莹%谢旭%梅树江%胡东生%周伯平%李兵%陈敬芳%崔富强%王富珍%梁晓峰
樑森%張順祥%馬起山%肖和衛%呂鞦瑩%謝旭%梅樹江%鬍東生%週伯平%李兵%陳敬芳%崔富彊%王富珍%樑曉峰
량삼%장순상%마기산%초화위%려추형%사욱%매수강%호동생%주백평%리병%진경방%최부강%왕부진%량효봉
肝炎病毒,乙型%乙型肝炎相关疾病%经济负担
肝炎病毒,乙型%乙型肝炎相關疾病%經濟負擔
간염병독,을형%을형간염상관질병%경제부담
Hepatitis B virus%Hepatitis B-related diseases%Economic burden
目的 明确深圳市乙型肝炎(乙肝)相关疾病的直接费用、间接费用和无形费用及探讨其影响因素.方法 采用时间阶段连续病例整群抽样方法,对符合条件的乙肝患者进行问卷调查;待患者出院后,收集住院费用及其相关信息.总费用包括直接、间接和无形费用.采用多元线性回归分析,对各种费用的影响因素进行探讨.结果 *乙肝所致相关疾病患者年均总费用为81 590.23元,其中直接、间接和无形费用分别为30 914.79元(37.9%)、15 258.01元(18.7%)和35 417.43元(占43.4%).原发性肝癌的总费用最高,为194 858.40元,其次为重型乙肝144 549.20元、失代偿期肝硬化120 333.60元、代偿期肝硬化79 528.81元、慢性乙肝66 282.46元、急性乙肝为39 286.81元.直接与间接费用之比为2.0∶1,其中原发性肝癌为0.7∶1、慢性乙肝2.2∶1、肝硬化2.5∶1、重型乙肝2.8∶1和急性乙肝3.3∶1;直接医疗费用大于直接非医疗费用(16∶1).乙肝相关疾病每例年均总费用占患者年均收入的比例为285.3%,占家庭年均收入的比例为75.4%;其中直接费用占患者和家庭年收入的比例分别为108.1%和28.6%.各类乙肝相关疾病患者间接费用合计为8123.38元,陪护间接费用为7134.63元,相应的误工天数分别为55.74 d和19.83 d.多元线性回归分析表明,年龄是各种费用的影响因素.结论 乙肝相关疾病患者和家庭承受着沉重的经济负担,随病情加重费用趋于增高;直接费用大于间接费用,直接医疗费用大于直接非医疗费用,患者误工费大于陪护误工费.
目的 明確深圳市乙型肝炎(乙肝)相關疾病的直接費用、間接費用和無形費用及探討其影響因素.方法 採用時間階段連續病例整群抽樣方法,對符閤條件的乙肝患者進行問捲調查;待患者齣院後,收集住院費用及其相關信息.總費用包括直接、間接和無形費用.採用多元線性迴歸分析,對各種費用的影響因素進行探討.結果 *乙肝所緻相關疾病患者年均總費用為81 590.23元,其中直接、間接和無形費用分彆為30 914.79元(37.9%)、15 258.01元(18.7%)和35 417.43元(佔43.4%).原髮性肝癌的總費用最高,為194 858.40元,其次為重型乙肝144 549.20元、失代償期肝硬化120 333.60元、代償期肝硬化79 528.81元、慢性乙肝66 282.46元、急性乙肝為39 286.81元.直接與間接費用之比為2.0∶1,其中原髮性肝癌為0.7∶1、慢性乙肝2.2∶1、肝硬化2.5∶1、重型乙肝2.8∶1和急性乙肝3.3∶1;直接醫療費用大于直接非醫療費用(16∶1).乙肝相關疾病每例年均總費用佔患者年均收入的比例為285.3%,佔傢庭年均收入的比例為75.4%;其中直接費用佔患者和傢庭年收入的比例分彆為108.1%和28.6%.各類乙肝相關疾病患者間接費用閤計為8123.38元,陪護間接費用為7134.63元,相應的誤工天數分彆為55.74 d和19.83 d.多元線性迴歸分析錶明,年齡是各種費用的影響因素.結論 乙肝相關疾病患者和傢庭承受著沉重的經濟負擔,隨病情加重費用趨于增高;直接費用大于間接費用,直接醫療費用大于直接非醫療費用,患者誤工費大于陪護誤工費.
목적 명학심수시을형간염(을간)상관질병적직접비용、간접비용화무형비용급탐토기영향인소.방법 채용시간계단련속병례정군추양방법,대부합조건적을간환자진행문권조사;대환자출원후,수집주원비용급기상관신식.총비용포괄직접、간접화무형비용.채용다원선성회귀분석,대각충비용적영향인소진행탐토.결과 *을간소치상관질병환자년균총비용위81 590.23원,기중직접、간접화무형비용분별위30 914.79원(37.9%)、15 258.01원(18.7%)화35 417.43원(점43.4%).원발성간암적총비용최고,위194 858.40원,기차위중형을간144 549.20원、실대상기간경화120 333.60원、대상기간경화79 528.81원、만성을간66 282.46원、급성을간위39 286.81원.직접여간접비용지비위2.0∶1,기중원발성간암위0.7∶1、만성을간2.2∶1、간경화2.5∶1、중형을간2.8∶1화급성을간3.3∶1;직접의료비용대우직접비의료비용(16∶1).을간상관질병매례년균총비용점환자년균수입적비례위285.3%,점가정년균수입적비례위75.4%;기중직접비용점환자화가정년수입적비례분별위108.1%화28.6%.각류을간상관질병환자간접비용합계위8123.38원,배호간접비용위7134.63원,상응적오공천수분별위55.74 d화19.83 d.다원선성회귀분석표명,년령시각충비용적영향인소.결론 을간상관질병환자화가정승수착침중적경제부담,수병정가중비용추우증고;직접비용대우간접비용,직접의료비용대우직접비의료비용,환자오공비대우배호오공비.
Objective To investigate the direct, indirect and intangible costs due to hepatitis B-related diseases and to explore main factors associated with the costs in Shenzhen. Methods Cluster sampling for cases collected consecutively during the study period was administrated. Subjects were selected fiom eligible hepatitis B-related patients. By pre-trained professional investigators,health economics-related information was collected, using a structured questionnaire. Hospitalization expenses were obtained through hospital records after the patients were discharged from hospital.Total economic burden of hepatitis B-related patients would involve direct, indirect and intangible costs. Direct costs were further divided into direct medical costs and direct nonmedical costs. Human Capital Approach was employed to measure the indirect costs both on patients and the caregivers in 1-year time span. Willing to pay method was used to estimate the intangible costs. Multiple linear stepwise regression models were conducted to determine the factors linked to the economic burden.Results On average, the total annual cost of per patient with hepatitis B-related diseases was 81 590.23 RMB Yuan. Among which, direct, indirect and intangible costs were 30 914.79 Yuan (account for 37.9% ), 15 258.01 Yuan (18.7% ), 35 417.43 Yuan (43.4%), respectively. The total annual costs per patient for hepatocellular carcinoma, severe hepatitis B, decompensated cirrhosis,compensated cirrhosis, chronic hepatitis B and acute hepatitis B were 194 858.40 Yuan, 144 549.20 Yuan, 120 333.60 Yuan, 79 528.81 Yuan, 66 282.46 Yuan and 39 286.81 Yuan, respectively. The ratio of direct to indirect costs based on the base-case estimation foot add to 2.0∶1, increased from hepato-eellular carcinoma (0.7∶1)to compensated cirrhosis (3.5∶ 1 ), followed by acute hepatitis B (3.3∶1 ), severe hepatitis B (2.8∶1 ), decompensate cirrhosis (2.3:1)and chronic hepatitis B(2.2∶1 ).Direct medical costs were more than direct nonmedical. Ratio between the sum total was 16∶1. The proportions of total annual cost per patient with hepatitis B-related diseases accounted for annual patient income were 285.3%, and 75.4% for annual household income. Furthermore, proportions of direct costs accounted for annual patient income and annual household income were 108.1% and 28.6%. The total annual indirect cost per person was 8123.38 Yuan for patients of all hepatitis B-related diseases, while 7134.63 Yuan for caregivers. Corresponding work-loss days were 55.74 days for patients and 19.83 days for caregivers. Based on multiple linear stepwise regression analysis, age of patients was a common influencing factor to all kinds of costs. Other factors were as follows:complicated with other diseases, antiviral medication, monthly household income and selfmedications. Conclusion The economic burden of hepatitis B-related diseases was substantial for patients and their families. All costs tended to increase with the severity of disease. The direct costs were larger than the indirect costs. And the direct medical costs were more than the direct ones.Indirect costs based on patients were larger than the ones of caregivers.
