我国伤害所致死亡损失生命年和经济负担分析

Analysis on years of life lost and economic burden caused by injury in China

目的 分析我国伤害所致疾病负担,为政府确定卫生工作的重点提供依据。方法 人口来源于《中国人口和就业统计年鉴2013》,伤害死亡数据来源于《中国卫生统计年鉴2013》,人均国内生产总值来源于《中国统计年鉴2013》,门诊费用和住院费用来源于国家卫生服务调查。采用全球疾病负担的方法,计算死亡损失生命年（years of life lost,YLLs）、直接和间接经济负担。结果 2012年我国伤害所致疾病负担强度为8.38 YLLs/1 000。疾病负担顺位的前5位为：机动车辆交通事故、自杀、意外跌落、机动车以外的运输事故和淹死。各类伤害所致疾病负担均存在农村高于城市、男性高于女性的特征。交通事故所致疾病负担主要集中在20-60岁年龄段,自杀疾病负担强度存在随年龄增加的趋势,意外跌落多见于老年人（60岁及以上）,淹死所致疾病负担主要集中在1-15岁年龄段。伤害所致总经济负担高达3 792.31亿元。结论 伤害给我国居民健康和社会经济造成了巨大损失,应加强对各类伤害尤其是交通事故、自杀、意外跌落和淹死的预防和干预。

Objective To estimate the burden of disease caused by injury and to help Chinese government to determine the priority for policy-making. Methods Demographic data was derived from China Population Employment Statistics Yearbook 2013,injury death from China Health Statistical Yearbook 2013,gross domestic product per capita from China Statistical Yearbook 2013,outpatient fee and inpatient fee from the National Health Services Surveys. Years of Life Lost（ YLLs） were calculated by the global burden of disease method as well as the direct and indirect economic burden.Results In 2012,the YLLs due to injury were 8. 38 per 1 000 people. The first five leading causes of the burden of disease caused by injury were motor vehicle traffic accidents,suicide,followed by falls,non-motorized vehicle traffic accidents and drowning. Every cause of the burden of injury was higher in rural than in urban area,and higher in male than in female. The burden of traffic accidents were mainly in the 20-60 age groups,while falling very common among older adults（ for example,60 years of age and older）,drowning mainly in the 1-15 age groups. The intensity of burden caused by suicide increased with age. The total economic burden due to injury were 3 792. 31 billion yuan. Conclusions Injury imposes substantial burden on residents＇ health and social economy. Effective preventions and interventions should be taken to control various kinds of injuries especially for traffic accidents,suicide,falls and drowning.