上海地区缺血性脑卒中患者实施规范化二级预防干预的药物费用负担

Study on drug cost burdens of standard secondary prevention for ischemic stroke patients in Shanghai

目的观察上海地区缺血性脑卒中患者实施规范化二级预防所需的药物费用负担。方法按照患者的危险因素分层及指南要求进行二级预防所需的药物费用的个体化测算,并结合患者的经济及享受医疗服务的状况,推测经济负担比例。结果 1698例患者中,享受医疗保险1544例(90.9%),药物费用占患者家庭人均收入20%以上者为56.7%,20%以下者为43.3%;自费患者154例,所有患者的药物费用占家庭人均收入的20%以上,逾八成患者的药物费用负担超过50%以上,40.9%(63/154)的患者所有收入不足以支付药费。结论上海地区缺血性卒中患者实施规范化二级预防的药物费用的负担沉重。

Objective To assess the drug cost burdens of standard secondary prevention in ischemic stroke patients in Shanghai area. Methods Drug costs of standard secondary prevention for ischemic stroke patients were calculated according to patients’ individual risk factors, health insurance status and the guideline recommendation. The economic burdens were estimated by dividing patients’ incomes with drug costs. Results Among a total of 1 698 patients,1 544 （90.9%） had health insurance, and 56.7% of them bore a drug cost which accounted for more than 20% of the mean individual income of a family. Drug cost more than 20% of the mean individual income of a family for all 154 patients with no insurance, and over 80% of them bore a drug cost which was more than 50% of their income; even worse, 40.9% of the patients without insurance had a drug expense more than their total incomes. Conclusion Drug cost burden for standard secondary prevention in ischemic stroke patients in Shanghai is heavy.