1301例肺结核患者的社会经济状况分析

Analysis of the socio-economic status of 1301 tuberculosis cases

目的描述和分析第五次结核病全国流行病学抽样调查(简称"流调")确诊为活动性肺结核患者的社会经济状况。方法对流调检出的1310例活动性肺结核患者,由受过培训的专业人员进行面对面问卷调查,共完成了1301例。问卷内容包括患者社会、经济状况及医疗费用等情况。结果被调查的患者中,文盲或半文盲占32.3%(420/1301),农民占59.2%(770/1301),无职业者占15.4%(201/1301),老年患者占48.8%(635/1301),70%以上者集中在中西部(965/1301)和农村地区(928/1301)。82.8%(1070/1293)的家庭年人均收入低于当地年人均收入。50.8%(555/1092)的患者个人收入达到家庭总收入1/2及以上。就诊期间医疗费用,新发现患者为360元(中位数),其中完全自付者占74.2%(161/217),灾难性支出者占16.9%(36/213);已确诊者为790元,其中完全自付者占62.5%(80/128),灾难性支出者占19.5%(26/133)。就诊期间因病误工者占21.1%(130/617),收入损失日均16.6～18.2元。结论肺结核患者社会经济地位低,罹患肺结核给家庭带来了收入来源减少和医疗费用支出的双重打击,是经济脆弱的特殊人群。建议国家加强对肺结核患者的关怀和补贴,并适当扩大免费诊断项目。

Objective To describe and analyze the socio-economic status of active tuberculosis patients detected in the fifth National Tuberculosis Epidemiological Sampling Survey.Methods 1301 cases out of 1310 active TB patients detected in the fifth National Tuberculosis Epidemiological Sampling Survey were interviewed face-to-face by the trained professionals with structured questionnaire including the socio-economic status and medical expenses.Results Among 1301 cases,32.3%（420/1301） cases were illiterates or semiliterates,59.2%（770/1301） were farmers,15.4%（201/1301） had no occupation,48.8%（635/1301） were 60-years old or above and more than 70% were distributed in the middle-western region（965/1301） or in rural areas（928/1301）.82.8%（1070/1293） cases had the annual family income per capita which were below the local average.50.8%（555/1092） had the personal income which were accounted for half of the total household income or above.For medical expenses during the diagnosis period,it was 360 yuan（median） for new cases,among whom 74.2%（161/217） paid the total medical expenses by themselves,and 16.9%（36/213） were in catastrophic expenditures.During the same period,it was 790 yuan（median） for known cases,among whom 62.5%（80/128） paid the total medical expenses by themselves,and 19.5%（26/133） were in catastrophic expenditures.Due to illness during the diagnosis period,21.1%（130/617） were in the loss of working time and the loss of income was 16.6-18.2 yuan per day.Conclusion Pulmonary tuberculosis cases have low socio-economic status and are special populations with fragile economy.Suffering from tuberculosis poses adouble whammy for the family with both the sources of income reduction and high medical expenses.It is recommended that the government should improve TB patients’ care and subsidies,and expand free items for diagnosis appropriately.