摘要
目的:比较研究不同结核病归口管理模式下肺结核病人的疾病经济负担。方法:采用分层整群随机抽样方法选取样本县,通过问卷调查了不同结核病归口管理模式下16个样本县中肺结核病人419例,利用经济学评价方法,探讨其疾病经济负担。结果:肺结核病人的人均疾病经济负担为3842元,不同模式间肺结核病人的疾病经济负担分别为3319元、4031元和4271元,总体上没有统计学上的显著差异,病人支出占纯收入比例达94.13%,占家庭纯收入比例达64.81%;在病人疾病经济负担中比例最高的为住院费,占22.40%,3种模式中均以住院费的比例最高,其次是护肝药费。肺结核病人在医院治疗的疾病经济负担总体上要比在疾控中心治疗高(F=7.45,P<0.05)。国家提供的免费额度占疾病经济负担的平均比例为17.18%,病人自身要承担疾病经济负担的83.02%。从疾病经济负担的回归分析中得出住院、首发症状严重程度、治疗机构等因素是导致高疾病经济负担的主要因素,住院因素导致患者疾病高疾病经济负担概率的OR值为11.47。结论:肺结核病人的疾病经济负担还是比较大,政府应该进一步加大投入,同时要严格控制住院比例、住院费用和辅助用药费用,以进一步降低肺结核病人的疾病经济负担。
Objectives The research makes careful investigation to anaylse tuberculosis pulmonary disease burden under different management model. Methods Randomized stratified clustered sampling method was used to select 16 example county and 419 tuberculosis pulmonary cases, and carry out operational research through questionnaire study. Utilizing economic evaluation to analyse diseases burden. Results The avarage tuberculosis pulmonary diseases burden was ￥3 842. Under three different management modes were ￥3 319, ￥4 031 and ￥4 271. It were not significantly different between different management modes. Compared with average absolute income of tuberculosis pulmonary patient,the ratio of disease expenditure was 94.13%, compared with average absolute family income, the ratio was 64.81%. In all kinds of expenditure in tuberculosis pulmonary diseases burden, the highest ratio fee was expenditure of be-in-hospital, was 22.40%, next was liver-drug fee. It was also like such in three different management modes. The average disease burden of tuberculosis pulmonary patient treated in general hospital was higher than in center for disease control and prevention（F=7.45, P〈0.05）. In average disease burden, the ratio of free supplied by goverment was 17.18%, the ratio of expenditure paied by patient was 83.04%. Through Logistic regression, it showed that be-in-hospital and primal severtity rate were main risk factor resulted in higher disease burden, the OR value of be-in-hospital was 11.47. Conclusions The avarage tuberculosis pulmonary diseases burden was high, the government should devote more fund to tuberculosis diease prevention, and we also should control rate of be-in-hospital. expenditure of be-in-hospital and expenditure of assistant durg strictly.
出处
《中国卫生经济》
2007年第2期58-61,共4页
Chinese Health Economics
关键词
结核肺
疾病经济负担
归口管理
tuberculosis pulmonary, disease burden, ccase-management model
