山东省农村糖尿病患者医疗经济负担及应对策略

Medical economic burden and coping strategy for diabetes mellitus patients in rural areas of Shanaong province

目的探讨山东省农村糖尿病患者治疗糖尿病的医疗经济负担及应对策略。方法采用多阶段分层随机抽样方法在山东省莒南、梁山、平阴3个县抽取的356例农村糖尿病患者进行入户问卷调查,分析糖尿病患者医疗经济负担及应对策略。结果山东省农村糖尿病患者例均年自付糖尿病治疗费用为2 793元,占家庭年人均收入的67.0%,其中例均门诊费用和住院费用分别为2 175和629元;有22.5%的患者因糖尿病治疗费用从非贫困变成贫困状态,整体贫困深度增加了2 472元;糖尿病患者主要采用家庭收入(63.8%)、亲朋支持(31.7%)、家庭积蓄(20.2%)等糖尿病费用应对策略;多因素logistic回归分析结果表明,家庭人口数较多的患者采用家庭收入策略的概率较高,采用亲朋支持的概率较低;年龄较大和自付医疗费用较高的患者采用亲朋支持策略的概率较高,采用家庭收入和积蓄策略的概率较低;家庭年人均收入较高患者采用家庭收入策略的概率较高。结论糖尿病给农村患者带来沉重的医疗经济负担,仅依靠家庭收入难以应对,应采用有效措施切实减轻糖尿病给患者造成的经济负担。

Objective To explore medical economic burden and coping strategy for diabetes mellitus patients in rural areas of Shandong province. Methods Multi-stratified sampling was used to select 356 rural diabetes mellitus patients from 3 counties in Shandong province and a face-to-face questionnaire survey was carried out in the patients. Results The average out-of-pocket medical expenditure of a diabetes patient was 2 793 RMB Yuan per year,which accounted for 66.9% of annual personal income,and the average out-patient and in-patient payment were 2 175 and 629 RMB Yuan,respectively.Of the patients,22.5% fell into poverty due to diabetes mellitus,and the poverty degree increased by 2 472 RMB Yuan.The percentage of family income,support from relatives or friends,and familial saving to cope with the medical expenditure was 63.8%,31.7%,and 20.2%,respectively.Family size,age,income and medical expenditure were main factors influencing the coping strategy. Conclusion Heavy medical economic burden of diabetes calls for more coping strategies.Effective measures should be taken to alleviate economic burden of diabetes mellitus patients.