195例农村孕产妇死亡造成的相关费用分析

Cost-of-illness analysis of 195 cases of maternal death in rural China

目的了解农村孕产妇死亡的疾病相关费用以及造成的家庭经济负担，为面向农村孕产妇死亡家庭的扶贫工作提供参考依据。方法从2009年6月至2010年10月对河北、河南和云南省农村地区共195个孕产妇死亡家庭在知情同意后进行入户调查，计算了孕产妇死亡相关的直接费用、间接费用以及由此造成的家庭经济负担，并分析了不同收入水平家庭的孕产妇死亡费用和经济负担。结果孕产妇死亡对每个家庭造成的费用中位数为18321元，其中直接费用中位数17500元，间接费用中位数666元。人均年收入越高的家庭，孕产妇死亡的总费用、直接费用和间接费用越高（相关系数分别为0．271、0．238、0．668，均P〈0．01）；而人均年收入越低，孕产妇死亡导致的总费用经济负担、直接费用经济负担越重（相关系数分别为-0．371和-0．381．均P〈0．01）。结论孕产妇死亡对于农村家庭造成了巨大的经济负担，提示政府扶贫工作应关注这部分家庭。

Objective To estimate the economic cost and economic burden of maternal death at household level, so as to provide valuable information for poverty alleviation of households with maternal death in rural China. Methods Data were collected using intervieweradministered questionnaires. Interviews were conducted between June 2009 and October 2010, with a sample of 195 households with maternal death in rural areas of Hebei, Henan and Yunnan province after informed consents were made. The direct cost, indirect cost and economic burden of maternal death were calculated, and the cost and economic burden among households of different income level were analyzed. Results The median of total maternal death-attributable cost to each household was 18 321 yuan, including median of direct cost of 17 500 yuan and median of indirect cost of 666 yuan. Households with higher income were associated with higher total cost, direct cost, and indirect cost （ correlation coefficient was 0. 271, 0. 238, and 0. 668, respectively, all P 〈 0. 01 ）. But the lower the annual income, the heavier the economic burden from total cost and direct cost （correlation coefficient was -0. 371 and -0. 381, respectively, both P 〈 0.01 ）. Conclusion High expenditure of households with maternal death indicates that government should concern the burden of maternal death-attributable spending.