| 丁慧,卢鹏,丁晓艳,李忠奇,竺丽梅,刘巧.江苏省233例耐多药/利福平耐药肺结核患者直接经济负担及影响因素研究[J].中华流行病学杂志,2024,45(9):1251-1257 |
| 江苏省233例耐多药/利福平耐药肺结核患者直接经济负担及影响因素研究 |
| Study on the direct economic burden and relevant influencing factors of 233 multidrug/rifampicin-resistant pulmonary tuberculosis patients in Jiangsu Province |
| 收稿日期:2024-03-11 出版日期:2024-09-14 |
| DOI：10.3760/cma.j.cn112338-20240311-00112 |
| 中文关键词: 结核，肺 耐多药 利福平耐药 直接经济负担 影响因素 |
| 英文关键词: Pulmonary tuberculosis Multidrug resistance Rifampicin resistance Direct economic burden Influencing factor |
| 基金项目:国家自然科学基金（82003516）；江苏省卫生健康委员会科研面上项目（M2020020）；江苏省卫生健康委员会科研重点项目（ZDA2020022） |
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| 中文摘要: |
| 目的 了解江苏省耐多药/利福平耐药肺结核（MDR/RR-PTB）患者直接经济负担及自付直接费用影响因素。方法 纳入2021年1月1日至2022年12月31日在江苏省13家市级结核病定点医院确诊治疗的MDR/RR-PTB患者，通过调查问卷和医院信息系统获得患者基本信息和直接经济费用。使用逐步多重线性回归分析患者自付直接费用的影响因素。结果 纳入的233例MDR/RR-PTB患者年龄为（44.04±15.64）岁。患者直接医疗费用M（Q1，Q3）为134 051.00（98 934.01，163 205.73）元，其中医保报销或政策减免费用M（Q1，Q3）为100 462.10（78 120.00，130 816.00）元，自付费用M（Q1，Q3）为21 694.62（14 734.83，37 813.00）元。直接非医疗费用M（Q1，Q3）为4 971.00（3 138.00，7 870.00）元。年龄、户籍所在地、结核病导致与配偶（伴侣）离异/分居、药敏情况和治疗方案是MDR/RR-PTB患者自付直接费用相关的影响因素。结论 MDR/RR-PTB对江苏省造成的直接经济负担较重。需重视耐药患者的心理疏导与关怀，进一步提高MDR/RR-PTB诊断、治疗和管理水平，切实减轻耐药患者经济负担。 |
| 英文摘要: |
| Objective To explore the direct economic burden and factors affecting out-of-pocket direct costs of multidrug-/rifampicin-resistant pulmonary tuberculosis (MDR/RR-PTB) patients in Jiangsu Province. Methods MDR/RR-PTB patients diagnosed and treated at 13 municipal tuberculosis (TB)-designated hospitals in Jiangsu Province between January 1, 2021, and December 31, 2022, were included, and basic information and direct economic costs were obtained through questionnaires and hospital information systems. Stepwise multiple linear regression was used to analyze the factors influencing patients' out-of-pocket direct costs. Results The age of the 233 MDR/RR-PTB patients was (44.04±15.64) years. The M(Q1, Q3) direct medical expense of the patients was 134 051.00 (98 934.01,163 205.73) Yuan, of which the M(Q1,Q3) reimbursement by health insurance or policy reduction was 100 462.10 (78 120.00,130 816.00) Yuan, and the M(Q1,Q3) out-of-pocket direct medical expense was 21 694.62 (14 734.83,37 813.00) Yuan. The M(Q1,Q3) direct non-medical expense was 4 971.00 (3 138.00,7 870.00) Yuan. Age, registered residence location, TB resulting in divorce or separation from spouse or partner, drug resistance test results, and treatment regimens were the influencing factors associated with out-of-pocket direct costs for MDR/RR-PTB patients. Conclusions The direct economic burden caused by MDR/RR-PTB in Jiangsu Province is heavy. It is necessary to emphasize psychological guidance and care for MDR/RR-PTB patients, improve the diagnosis, treatment, and management of MDR/RR-PTB, and effectively reduce the economic burden of MDR/RR-PTB patients. |
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