2008-2009年天津市病毒性腹泻病例疾病负担分析

The analysis of disease burdern of viral diarrhea cases in Tianjin during 2008-2009

目的评价天津市病毒性腹泻病例疾病负担,为制定防控政策提供科学依据。方法采用面对面现场询问的方法 ,参考家庭负担会谈量表自制问卷,调查被调查对象一般情况和相关费用及家庭负担。采集病例粪便标本进行实验室检测。结果天津市2008-2009年951例病毒性腹泻病例人均总费用为178.8元,5岁以下的门诊病例(3640.5元)和住院病例(4434.5元)的人均费用分别是5岁及以上病例的3.23倍和6.24倍,5岁以下组病例感染诺如病毒直接医疗费用要高于轮状病毒(P<0.05),感染轮状病毒比诺如病毒对家庭成员收入和家庭娱乐活动影响要大(P<0.05);而5岁及以上组病例,感染轮状病毒的直接费用要高于诺如病毒(P<0.05),而诺如病毒造成的家庭负担最重(P<0.05)。结论病毒性腹泻病例中5岁以下儿童经济负担重,并且感染诺如病毒比轮状病毒的疾病负担高,建议将有效的肠道病毒疫苗列为计划免疫范畴。

Objective To evaluate the disease burden of viral diarrhea cases in Tianjin so as to provide the scientific basis for decision making. Methods To investigate the basic situation of the patients＇ families, the treatment-related cost and family burden by the face-to-face interview with the self-designed questionnaire of diseases burden scale. Stool specimens were taken from cases for laboratory test. Results Nine hundred and fifty one diarrhea cases in Tianjin during 2008-2009 were investigated and the average total cost was 178.8$. The average cost （3 640.5$） of outpatient cases under 5 year-old group was 3.23 times compared with that of cases over 5 year-old group,and the average cost （4 434.5$） of inpatient cases under 5 years was 6.24 times compared with that of cases over 5 year-old. For cases under 5 year-old group, the direct medical cost of norovirus infectious cases was higher than that of rotavirus infectious cases （P0.05）, but rotavirus infectious cases had more influence to the familes＇ income and entertainment activities than norovirus infectious ones （P0.05）. For cases over 5 year-old group, the results are opposite compared with cases under 5 year-old group. Conclusions The family with viral diarrhea cases under 5 year-old group has heavy disease burden, and the family with infectious rotavirus cases has heavier burden than the ones with infectious norovirus. Rotovirus vaccine should be put into planned immunization program.