凉山彝族地区艾滋病抗病毒治疗直接经济负担及其影响因素分析

Antiretroviral therapy related direct economic burden and its impact factors in patients living with HIV/AIDS in Liangshan Yi Autonomous Region

目的研究四川省凉山州彝族地区艾滋病抗病毒治疗者直接经济负担现状和影响因素,为完善已有医疗保障、医疗救助和健康扶贫政策提供参考依据。方法 2017年10月-2018年1月采用多阶段整群抽样,选取凉山地区2017年10月前正在接受抗病毒治疗且治疗时间>1年的患者185例。通过自制调查问卷收集相关信息。采用多元回归模型分析直接经济负担的影响因素。结果 B、G、M、X和Z地的调查对象疾病直接经济负担均数分别为1 422.8、772.1、11 402.5、4 092.8和1 675.6元/人年。汉族(6315.9元/人年)远远高于彝族(1 946.3元/人年),城市地区(3 584.4元/人年)直接经济负担高于农村(2 409.5元/人年),低保人群(4 024.4元/人年)高于一般人群(1 737.8元/人年)。居住地(t=-2.043,P<0.05)、疼痛(P<0.05)、是否继续工作(P=0.006)为艾滋病抗病毒治疗者直接经济负担的影响因素。结论凉山彝族地区艾滋病抗病毒治疗直接经济负担水平相比国内其他疫情严重地区而言较低,其中M地区的直接经济负担最高。

Objective To examine direct economic burden and its influencing factors of antiretroviral therapy(ART)among human immunodeficiency virus infection/acquired immunodeficiency syndrome(HIV/AIDS) patients in Liangshan Yi Autonomous Region(Liangshan) of Sichuan province, and to provide references for improving the medical insurance and assistance and health poverty alleviation policies. Methods Using multistage cluster sampling and a self-designed questionnaire, we conducted a survey among 185 HIV/AIDS patients having ART of more than one year till October 2017 in5 urban and rural areas of Liangshan during the period from October 2016 to January 2017. Multivariate regression model was adopted to analyze impact factors of the direct economic burden. Results The average direct costs of the disease for the patients in the five areas were 1 422.8, 772.1, 11 402.5, 4 092.8 and 1 675.6 yuan(RMB)/per person year. Compared to those among the Yi patients, rural patients, and the patients with normal living condition, higher direct costs(in yuan) were reported by the Han patients(6 315.9 vs. 1 946.3), urban patients(3 584.4 vs. 2 409.5), and the patients with subsistence allowance(4 024.4 vs. 1 737.8). Main influencing factors for direct economic burden of the patients included place of residence(t =-2.043, P < 0.05), pain symptom(P < 0.05), and whether continuing to work(P = 0.006). Conclusion The direct economic burden of HIV/AIDS patients with antiretroviral therapy in Liangshan is lower than that of the patients in other part China and the burden differs among the patients in different areas.