农村老年人尿失禁治疗情况和疾病负担研究

Treatment and economic burden of urine incontinence in the rural elderly

目的探讨农村老年人尿失禁治疗情况及其所带来的疾病负担，为老年人尿失禁的干预提供依据。方法2007--2008年在天津市蓟县采用整群抽样的方法，以洇溜卫生院和大塾上卫生院所管辖的5个村庄的60岁及以上老年人为调查对象，共获有效问卷743份，对老年人尿失禁的一般情况、就诊情况和直接经济负担进行统计分析。结果743例中尿失禁248例（33．4％），曾在社区卫生服务中心或医院就诊者12例（4．8％），治疗方法均为药物治疗；其中患病1年内就诊1例、1～5年内就诊8例、5年或以上就诊3例。248例尿失禁患者中，227例（91．5％）未采取任何治疗措施，9例（3．6％）自行去药店买药服用、未就诊。治疗尿失禁的直接医疗费用为80～12000元，其中100元以下的2例，100～1000元的2例，1001～5000元的7例，10000元以上的1例。结论天津市蓟县老年人尿失禁患病率高，就诊率低，就诊患者承受较大的经济负担，应采取相应的干预策略预防老年人尿失禁。

Objective To explore the treatment and economic burden of urine incontinence （UI） in the rural elderly, and provide evidences for preventive intervention. Methods A cluster sampling was carried out in 743 people （aged 60 years and over） from 5 villages dominated by Yanliu and Dafengshang health centers, Jixian County, Tianjin from 2007 to 2008. The information about general state of health, treatment and economic burden of disease were analyzed. Results The prevalence of UI was 33.4% （248 cases） among the 743 elderly people. Only 12 patients （4.8%） with UI ever visited community health-care service centers or hospitals for diagnosis and treatment, among whom only 1 case visited hospital within 1 year, 8 cases during 1 to 5 years, and 3 cases over 5 years. And the method of treatment was all drug therapy. Among 248 cases with UI, there were 227 cases （91.5%） without any treatment, 9 eases （3.6%） buying medicines by themselves. The direct cost for treatment of UI was 80 12000 yuan RMB, including 2 cases below 100 yuan RMB, 2 cases 100-1000 yuan RMB, 7 cases 1001-5000 yuan RMB and 1 case over 10000 yuan RMB. Conclusions Prevalence of UI is high while hospital-visiting rate is very low, and the financial burden of disease is serious, thus intervention measures for UI should be taken for the elderly people in rural areas of Jixian County, Tianjin.