广州市SARS病例经济负担研究

Economic burden of SARS patients in Guangzhou

目的估计2003年广州市SARS确诊病例的疾病经济负担和分析住院费用的影响因素。方法收集2003年广州市1 059例SARS确诊病例住院资料及问卷调查339例SARS确诊病例的流行病学资料,根据其住院费用、医疗相关费用和DALY指标计算直接经济负担和间接经济负担。结果2003年广州市1 283例SARS临床确诊病例的总经济负担为5 174.57万元,其中直接经济负担3 107.66万元,间接经济负担2 066.91万元,人均经济负担4.03万元。直接负担中病例的住院费用占83.66%,药费占住院费用比例最高,为54.19%,病例人均住院费用20 263.21元。间接负担中死亡病例的寿命损失年YLLs值为654.73,折算成经济指标后为1 489.43万元,占间接负担的72.06%;存活病例的误工损失为577.48万元。职业、年龄、入院时间、医院级别和住院天数是住院费用的影响因素(P<0.01)。结论SARS确诊病例的人均经济负担较高,直接经济负担高于间接经济负担,直接经济负担以住院费用为主;制定策略降低住院费用对减轻SARS的经济负担具有重要意义。

Objective To analyze the economic burden and related factors of SARS patients in Guangzhou. Methods Ch＇nical records of 1059 SARS patients and epidemiological survey questionnaires of 339 cases were collected to calculate direct and indirect economic costs. Results The total economic burden of 1 283 SARS cases was 51. 745 7 millions RMB with direct, indirect and personal costs 31. 076 6 millions RMB, 20. 669 1 millions RMB and 40. 3 thousands RMB respectively. The hospital cost accounted for 83.66% of direct economic burden with 20. 263 21 thousands RMB per case and drug expenses took the largest proportion（54. 19% ）. The YLLs of death cases was 654. 73 and caused 14. 894 3 millions RMB loss which accounted for 72. 06% of indirect economic burden after transforming into economic index. The labour loss of survival cases was 5. 774 8 millions RMB. Occupation, age, stage of inpatient, class of hospital,days of hospitalization significantly impacted hospital charges （P 〈 0. 01 ）. Conclusion The SARS cases bore heavy economic burden and direct economic burden which clinical cost took the largest proportion was higher than indirect economic burden.