乙型病毒性肝炎相关疾病患者住院经济负担及影响因素调查研究

Study on Economic Burden of Inpatients with Hepatitis B Virus Related Diseases and Influencing Factors

目的调查乙型病毒性肝炎(乙肝)相关疾病患者住院经济负担及影响因素,为制定减轻疾病经济负担的卫生政策提供依据。方法采用时间阶段连续病例抽样方法,选择2012年8—12月因乙肝相关疾病在县级医疗机构住院的患者196例,其中急性乙肝3例、慢性乙肝141例、肝硬化代偿期18例、肝硬化失代偿期22例、肝癌12例,按照疾病经济负担理论和方法计算直接经济负担和间接经济负担。采用多元线性逐步回归法分析乙肝相关疾病患者住院经济负担的影响因素。结果 196例住院患者次均经济负担28 971元,其中直接经济负担19 916元(68.7%),间接经济负担9 055元(31.3%);直接经济负担中直接医疗费用19 087元(95.8%),直接非医疗费用829元(4.2%);间接经济负担中患者费用6 348元(70.1%),陪护费用2 707元(29.9%)。多元线性逐步回归分析结果显示,住院天数、药品比例、年龄、疾病类型与乙肝相关疾病患者住院经济负担有回归关系(P<0.05)。结论乙肝相关疾病患者住院经济负担较重,直接经济负担占主要部分,通过合理缩短住院天数、适当控制药品比例、延缓疾病进展可以降低经济负担。

Objective To investigate the economic burden of inpatients with hepatitis B virus related diseases and its influencing factors in order to provide basis for health policy for alleviating the burden. Methods Time phasing continuous sam- piing was used to select 196 inpatients with HBV - related diseases in county hospitals from August 2012 to December. Among these patients, 3 were acute hepatitis B, 141 were chronic hepatitis B, 18 were compensated cirrhosis, 22 were decompensated cirrhosis and 12 were liver cancer. Direct and indirect economic burden were calculated according to theory and methods of disease economic burden. Stepwise multivariate linear regression analysis was used to study the influencing factors. Results Among the 196 inpatients, the average economic burden was RMB 28 971, which included RMB 19 916 direct economic burden （68.7%） and RMB 9 055 indirect economic burden （31.3%） . The direct economic burden was further divided into medical cost of RMB 19 087 （95.8%） and non -medical cost of RMB 829 （4. 2% ） . The indirect economic burden was further divided into patients cost of RMB 6 348 （70. 1% ） and caregivcr cost of RMB 2 707 （29. 9% ） . Multiple regression analysis showed that days of hos- pitalization, drugs ratio, age and disease type were influencing factors （ P 〈 0.05 ） . Conclusion Economic burden of inpa- tients with HBV -related diseases is heavy, with direct economic burden accounting for the major part of it. Reasonable shorter hospital stay, proper control of the drug ratio and delay of disease development could reduce the economic burden of disease. r l[,r ,.t^l