1993-2003年中国城乡地区结核病患者经济负担对比[JP

Difference of economic burden caused by TB between urban and rural areas in China from 1993 to 2003

目的 对比1993-2003年10年间中国城乡地区结核病患者的经济负担.方法 利用三次全国卫生服务家庭调查数据以及常规医院统计和全国死因监测数据,通过疾病经济负担分析方法,测算中国1993-2003年间城市和农村地区结核病患者的直接经济负担、间接经济负担和总经济负担,分析经济负担构成并比较城乡差异.结果 1993年城市地区结核病造成的经济负担约为13.5亿元,到2003年达到46.4亿元;农村地区结核病总经济负担在1993年为29.2亿元,到2003年已达到63.7亿元;同期农村结核病经济负担比城市更重.10年间无论城乡结核病经济负担均有增加,城市地区涨幅（2.4倍）略高于农村地区（2.2倍）.从结核病经济负担结构分析,除1993年城市地区之外,均以直接经济负担比重更大,2003年农村地区结核病的直接经济负担几乎接近80%.10年间中国总的疾病经济负担增长迅速,超过GDP增速,结核病虽然在总疾病经济负担中的比重略有下降,但仍在1%左右,而且在传染病经济负担中的比重持续上升.结论 1993-2003年10年间结核病在城乡地区均造成了沉重的疾病负担,因此无论在城市还是农村,结核病仍然应当作为防控工作的重点.为了有效地控制结核病引起的疾病负担,重点要加强对其直接费用的控制,特别是在农村地区.

Objective To estimate the economic burden caused by TB （tuberculosis） and its proportion and compare the difference between urban and rural areas in China from 1993 to 2003. Methods Using data from 3 National Health Service Surveys and routine haspital-based statistics and surveillance, the health economic analysis methods were selected and the burden of diseases, including direct and in-direct economic burden, were calculated separately. Results In urban areas, the economic burden caused by TB was 1.35 billion RMB in 1993 and 4.64 billion RMB in 2003. In rural areas, the economic burden caused by TB was 2.92 and 6.37 billion RMB in 1993 and 2003 separately. The economic burden was heavier in rural areas than in ur- ban areas~ The economic burden of TB increased in 10 years and increased more rapidly in urban （2.4 times） than in rural areas （2.2 times）. The direct ecorromie burden generally contributed more than in-direct economic burden to total burden of TB. The total economic burden of diseases increased more rapidly than the increasing rate of GDP in China~ The proportion of economic burden of TB decreased while it was still equal to about 1% of total burden of diseases~ Conclusion The main findings indicate that to control TB effectively will be very important for decreasing the burden of diseases in China and more efforts should be taken to control the direct medicine costs, especially in rural areas~