CAJ | 학술논문

目的：研究慢性乙型病毒性肝炎（慢性乙肝）相关疾病患者经济负担，探讨影响经济负担的相关因素。方法对宁波市630例慢性乙肝相关疾病住院患者进行问卷调查，出院后查阅病历，摘录住院费用并计算过去一年的直接费用。分别以直接医疗费用、直接非医疗费用和直接费用为应变量建立逐步多元线性回归，筛选影响费用的因素。结果宁波市平均1例慢性乙肝相关疾病患者年直接医疗费用、直接非医疗费用和直接费用分别为61606.78、3532.73和65139.51元。直接费用原发性肝癌最高，为123571.78元，其余依次为慢性重型乙肝93278.65元，肝硬化82467.99元，慢性乙肝21824.31元。直接医疗费用和直接非医疗费用平均比值为17.44，原发性肝癌、肝硬化、慢性重型乙肝和慢性乙肝依次为19.17、15.52、21.62和17.02。患者年均直接费用是患者个人年收入的1.75倍，家庭收入的1.02倍。患者职业、合并其他疾病、出院诊断分类和个人年收入等因素均分别是直接费用（包括直接医疗费用和直接非医疗费用）的相关因素。结论宁波市乙肝相关疾病患者经济负担沉重。直接医疗费用大于直接非医疗费用；随着疾病的加重，直接医疗费用增加。
목적：연구만성을형병독성간염（만성을간）상관질병환자경제부담，탐토영향경제부담적상관인소。방법대저파시630례만성을간상관질병주원환자진행문권조사，출원후사열병력，적록주원비용병계산과거일년적직접비용。분별이직접의료비용、직접비의료비용화직접비용위응변량건립축보다원선성회귀，사선영향비용적인소。결과저파시평균1례만성을간상관질병환자년직접의료비용、직접비의료비용화직접비용분별위61606.78、3532.73화65139.51원。직접비용원발성간암최고，위123571.78원，기여의차위만성중형을간93278.65원，간경화82467.99원，만성을간21824.31원。직접의료비용화직접비의료비용평균비치위17.44，원발성간암、간경화、만성중형을간화만성을간의차위19.17、15.52、21.62화17.02。환자년균직접비용시환자개인년수입적1.75배，가정수입적1.02배。환자직업、합병기타질병、출원진단분류화개인년수입등인소균분별시직접비용（포괄직접의료비용화직접비의료비용）적상관인소。결론저파시을간상관질병환자경제부담침중。직접의료비용대우직접비의료비용；수착질병적가중，직접의료비용증가。
Objective To explore the economic burden of chronic hepatitis B -relevant diseases and to understand the factors associated with the economic burden. Methods Economic - related information was collected by questionnaire investigation in Ningbo City. Hospital records and hospitalization expenses were obtained when 630 patients discharged from hospital. Influencing factors of the economic burden were analyzed by stepwise multiple linear regressions. Results The average of the total cost for the diseases was 65 139. 51 Yuan. Direct medicinal and non-medical costs were 61 606. 78 Yuan and 3 532. 73 Yuan respectively. The total annual costs for primary carcinoma of the liver,chronic severe hepatitis B,Hepatitis cirrhosis and chronic hepatitis B were 123 571. 78 Yuan,93 278. 65 Yuan,82 467. 99 Yuan and 21 824. 31 Yuan respectively. The average ratio of direct medical to direct non-medical cost was 17. 44,in which primary carcinoma of the liver,hepatitis cirrhosis,chronic severe hepatitis B,chronic hepatitis B were 19. 17,15. 52,21. 62 and 17. 02 respectively. The total cost was 1. 75 times higher than annual income of individual,as well as 1. 02 times higher than household income. Occupation,complication,income,diagnosis results were the influencing factors for economic burden. Conclusion The economic burden of chronic hepatitis B-relevant diseases was enormous in Ningbo City. The cost of direct medical was larger than direct non -medical. Expenses increased dramatically as the disease progressed to more advanced stage.