| 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.深圳市乙型肝炎相关疾病经济负担及其影响因素分析[J].Chinese journal of Epidemiology,2010,31(12):1340-1345 |
| 深圳市乙型肝炎相关疾病经济负担及其影响因素分析 |
| Financial burden of hepatitis B．reiated diseases and factors influencing the costs in Shenzhen．China. |
| Received:July 20, 2010 |
| DOI：10.3760/ema.j.issn.0254—6450.2010.12.004 |
| KeyWord: 肝炎病毒，乙型 乙型肝炎相关疾病 经济负担 |
| English Key Word: Hepatitis B virus Hepatitis B-related diseases Economic burden |
| FundProject:“十一五”国家科技重大专项(2008ZXl0002-001) |
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| Abstract: |
| 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.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.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2:1、肝硬化2.5:1、重型乙肝2.8:l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.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.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. |
| English Abstract: |
| Objectlve 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．Subiects were selected from 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 earegivers 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 pailent with hepatitis B—related diseases was 8l 590．23 RMB Yuan．Among which．direct．indirect and intangible costs were 30 914．79 Yuan (account for 37．9％)，15 258．0l Yuan(1 8．7％)，35 417．43 Yuan(43．4％)。respectively．The total annuai costs per patient for hepatocellular carcinoma．severe hepatitis B，decompensated eirrhosis， compensated cirrhosis．chronic hepatitis B and acute hepatitis B were 194 858．40 Yuan，144 549．20 Yuan。120 333．60 Yuan．79 528．8l Yuan。66 282．46 Yuan and 39 286．8l Yuan，respectively．The ratio of direct to indirect costs based on the base—case estimation foot add to 2．0：1．increased from hepato．cellular carcinoma(0．7：1)to compensated cirrhosis(3．5：1)，followed by acute hepatitis B (3．3：1)，sevgre 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 1 6：1．11le proportions of total annual cost per patient with hepatitis B．relaP,,d 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 l 08．1％and 28．6％．The total annual indirect cost per person was 8 123．38 Yuan for patients of all hepatitis B—related diseases．while 7134．63 Yuan for caregivers．Corresponding work-loss days were 55．74 clays for patients and l 9．83 days for caregivers．Based on multiple linear stepwise regression analysis．age of patients was a common influencing factor to ail 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．A11 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 caregivcrs． |
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