天津市中老年人群主要慢性病患病状况及疾病直接经济负担分析

Analysis on the Prevalence of Main Chronic Diseases and their Direct Economic Burden among the Middle-aged Population in Tianjin

目的了解天津市中老年人群主要慢性病的患病状况及疾病直接经济负担。方法采用多阶段随机整群抽样方法,于2008年在天津市随机抽取了3个区和3个县的45岁以上、具有该市户籍的1255名常住居民进行人口学特征、主要慢性病病史及病伤、住院情况调查。利用二步模型法进行疾病直接经济负担测算。结果共有效调查1248名中老年人群,男性588人,女性660人,农村721人,城区527人,平均年龄(61.0±6.3)岁。高血压患病率为65.0%,男性(72.1%)高于女性(58.6%),城市(75.7%)高于农村(57.1%),差别均有统计学意义(P<0.01)。糖尿病患病率为16.7%,其中男性为15.6%,女性为17.6%,城市(23.3%)高于农村(11.8%),差别有统计学意义(P<0.01)。不同文化程度者高血压及糖尿病患病率不同。月经济收入高于3000元者糖尿病患病率最高(35.4%)。652名单纯高血压患者年疾病直接经济负担为3300665元,年直接医疗费用为3220543元(占97.6%)。49名单纯糖尿病患者年疾病直接经济负担为212886元,年直接医疗费用为210050元(占98.7%)。高血压合并糖尿病患者人均年疾病直接经济负担最高(8591.32元),其次是单纯患高血压(5062.37元)、糖尿病(4344.61元)。结论天津市中老年人群高血压和糖尿病的患病率较高,疾病直接经济负担严重,需采取针对性措施加以控制。

Objeetive To know the prevalence and direct economic burden of main chronic diseases among the middle-aged population in Tianjin. Methods 1 255 permanent residents aged over 45 years old were sampled by using multi-stage random sampling method in 3 districts and 3 Counties of Tianjin, and the direct economic burden of diseases was calculated and estimated with two-step model method. Results The effective cases were 1 288, including male 588 and female 660, rural 721 and urban 527, the mean age was （61.0 ± 6.3） years. The prevalence rate of hypertension was 65.0%, male＇s （72.1%） higher than female＇s （58.6%）, in urban （75.7%） higher than in rural （57.1%）, all differences were significant （P〈0.01）. Diabetes prevalence was 16.7%, 15.6% in males and 17.6% in females, 23.3% in urban and 11.8% in rural, all these differences were statistically significant （P〈0.01）, the rate was the highest （35.4%） in people with monthly income above 3 000 Yuan. Among 652 simple hypertensive patients, their total direct disease burden was 3 300 665 Yuan per year, the annual direct medical cost was 3 220 543 Yuan （accounts for 97.6%）. Among 49 patients with simple diabetes, the annual direct disease economic burden was 212 886 Yuan, the annual direct medical cost was 210 050 Yuan （accounting for 98.7%）. The per capita annual direct economic burden of patients simultaneously suffering hypertension and diabetes was the highest （8 591.32 Yuan）, followed by patients with simple hypertension （5 062.37 Yuan）, and patients with diabetes （4 344.61 Yuan）. Conclusion The prevalence of hypertension and diabetes in the middle-aged population in Tianjin is still higher, and its direct disease economic burden is heavier, so the targeted measures should be taken for the control.