中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2011年
8期
764-767
,共4页
马起山%邹宇华%张顺祥%梁森%肖和卫%谢旭%梅树江%贾卫东%张宇锋%崔富强%王富珍%梁晓峰
馬起山%鄒宇華%張順祥%樑森%肖和衛%謝旭%梅樹江%賈衛東%張宇鋒%崔富彊%王富珍%樑曉峰
마기산%추우화%장순상%량삼%초화위%사욱%매수강%가위동%장우봉%최부강%왕부진%량효봉
乙型肝炎相关疾病%无形费用%支付意愿法
乙型肝炎相關疾病%無形費用%支付意願法
을형간염상관질병%무형비용%지부의원법
Hepatitis B-related diseases%Intangible cost%Willingness to pay
目的 了解乙型肝炎(乙肝)相关疾病住院病例年均无形费用以及占总费用的比例和影响因素,探讨无形费用的调查方法.方法 利用自制结构式问卷,对乙肝相关疾病住院病例进行面对面询问,比较支付意愿法三种引导技术获得的无形费用数值特征;采用多元线性回归分析,探讨无形费用的影响因素.结果 开放式估价和重复投标式相结合调查得到564例乙肝相关疾病患者年无形费用均值为54 320.4元,占总费用的比例为53.0%,高于直接费用和间接费用所占比例(分别为38.5%和8.5%),即乙肝相关疾病无形费用占总费用的比例较高.无形费用占患者和家庭年收入的比例分别为262.6%和67.6%,形成沉重的经济负担.开放式估价、开放式估价和重复投标式结合、支付卡式三种引导技术的反映率分别为55.9%、76.6%和74.7%;综合比较发现,开放式估价和重复投标式结合技术获得的结果较为合理.乙肝相关疾病患者的无形费用高低与疾病的严重程度关系不明显;无形费用12个可能的影响因素中,医院类型和是否购买商业医疗保险进入多元线性回归模型.结论 在降低乙肝相关疾病直接和间接费用的同时,应采取措施降低其无形费用;支付意愿法中开放式估价和重复投标式结合作为乙肝相关疾病无形费用调查的引导技术较为可靠.
目的 瞭解乙型肝炎(乙肝)相關疾病住院病例年均無形費用以及佔總費用的比例和影響因素,探討無形費用的調查方法.方法 利用自製結構式問捲,對乙肝相關疾病住院病例進行麵對麵詢問,比較支付意願法三種引導技術穫得的無形費用數值特徵;採用多元線性迴歸分析,探討無形費用的影響因素.結果 開放式估價和重複投標式相結閤調查得到564例乙肝相關疾病患者年無形費用均值為54 320.4元,佔總費用的比例為53.0%,高于直接費用和間接費用所佔比例(分彆為38.5%和8.5%),即乙肝相關疾病無形費用佔總費用的比例較高.無形費用佔患者和傢庭年收入的比例分彆為262.6%和67.6%,形成沉重的經濟負擔.開放式估價、開放式估價和重複投標式結閤、支付卡式三種引導技術的反映率分彆為55.9%、76.6%和74.7%;綜閤比較髮現,開放式估價和重複投標式結閤技術穫得的結果較為閤理.乙肝相關疾病患者的無形費用高低與疾病的嚴重程度關繫不明顯;無形費用12箇可能的影響因素中,醫院類型和是否購買商業醫療保險進入多元線性迴歸模型.結論 在降低乙肝相關疾病直接和間接費用的同時,應採取措施降低其無形費用;支付意願法中開放式估價和重複投標式結閤作為乙肝相關疾病無形費用調查的引導技術較為可靠.
목적 료해을형간염(을간)상관질병주원병례년균무형비용이급점총비용적비례화영향인소,탐토무형비용적조사방법.방법 이용자제결구식문권,대을간상관질병주원병례진행면대면순문,비교지부의원법삼충인도기술획득적무형비용수치특정;채용다원선성회귀분석,탐토무형비용적영향인소.결과 개방식고개화중복투표식상결합조사득도564례을간상관질병환자년무형비용균치위54 320.4원,점총비용적비례위53.0%,고우직접비용화간접비용소점비례(분별위38.5%화8.5%),즉을간상관질병무형비용점총비용적비례교고.무형비용점환자화가정년수입적비례분별위262.6%화67.6%,형성침중적경제부담.개방식고개、개방식고개화중복투표식결합、지부잡식삼충인도기술적반영솔분별위55.9%、76.6%화74.7%;종합비교발현,개방식고개화중복투표식결합기술획득적결과교위합리.을간상관질병환자적무형비용고저여질병적엄중정도관계불명현;무형비용12개가능적영향인소중,의원류형화시부구매상업의료보험진입다원선성회귀모형.결론 재강저을간상관질병직접화간접비용적동시,응채취조시강저기무형비용;지부의원법중개방식고개화중복투표식결합작위을간상관질병무형비용조사적인도기술교위가고.
Objective To estimate the intangible cost and associated factors on patients with hepatitis B-related diseases, so as to explore the differences of the three elicitation techniques on the health economics-related information by trained investigators, using a structured questionnaire. WTP was employed to estimate the intangible cost while an open-ended question format, together with iterative bidding game and payment card were respectively used to elicit WTP for the hypothetical cure of hepatitis B-related diseases. A Multiple linear stepwise regression model was determined to identify those factors potentially affecting the intangible cost. Results A total of 564 subjects from 641 patients with hepatitis B-related diseases were identified for the inclusion of this study. The average annual intangible cost of patient with hepatitis B-related diseases was 54 320.4 Yuan (Ren Minbi).The intangible cost accounted for 53.0% of the total cost, which was much more than the proportions of the direct and indirect costs (38.5% and 8.5%, respectively). Among annual personal and the household income of the patient, proportions of intangible cost were 262.6% and 67.6% respectively,suggesting that the patients were under huge spiritual and psychological pressure. Response rate of the approach, combined open-ended questions with iterative bidding game, was the highest (76.6%) among the three elicitation formats. Considered the characteristics of data being gathered, the approach seemed to be more reasonable. Further studies were needed to examine the results yielded from other WTP elicitation formats. We also noticed that the progression of disease was associated with the increase of direct and indirect costs, but not with the intangible cost. Data from the multiple linear stepwise regression analysis indicated that the types of hospital and commercial medical insurance were significantly different in explaining the variation of the intangible cost. Conclusion Measures should be taken to reduce the intangible cost of hepatitis B-related diseases. The approach regarding the combination of open-ended questions with iterative bidding game should be recommended when carrying our further WTP studies of this kind.
