应用条件价值法评估广州市工伤脊髓损伤患者疾病经济负担

The application of contingent valuation method in assessing the economic burden of patients with work-related spinal cord injury in Guangzhou

目的使用条件价值法评估工伤脊髓损伤患者因脊髓损伤造成的经济负担,并对其影响因素进行初步分析。方法按照纳入排除标准,采用非随机抽样,通过面谈或电话访谈的形式对79例工伤脊髓损伤患者进行问卷调查,填写自行设计的一般情况和支付意愿调查表、健康相关生命质量问卷36简表(SF-36)。采用条件价值评估法中支付卡式引导技术、SF-6D效用评分模型和多元线性回归模型。结果工伤脊髓损伤患者对其经济福利损失估计值为48129.15元/年,占被调查者个人伤后年均收入的88.33%,家庭年收入的56.08%。个人收入和家庭规模对WTP有正向影响。结论使用条件价值评估法对不同疾病的经济福利损失或疾病经济负担进行估计时,需要考虑收入的影响。包括脊髓损伤在内的灾难性疾病或损伤对个人经济福利损失可能趋近与死亡。经济补偿对降低伤者经济福利损失的作用具有局限性,政府应该更加注重残疾管理,加强社会资源的支持,促进其社会和工作回归,减少因伤残带来的家庭、社会网络、社交和工作变化引起的非市场的经济福利损失。此外,对于这种灾难性伤害,加强预防的意义尤其重要。

Objective To assess the financial burden of spinal cord injury in patients with work-related spinal cord injury by using the willingness to pay method, and to analyze the influencing factors preliminarily. Methods A questionnaire survey was conducted among 79 patients with work-related spinal cord injuries with interviews or telephone interviews according to inclusion and exclusion criteria by non random sampling. Self designed survey questionnaire for general situation and willingness to pay and health related quality of life survey questionnaire 36 （SF-36） were filled in. Payment card guidance technique of contingent valuation method, SF-6D utility scoring model and multiple linear regression model were adopted. Results The estimated loss of economic welfare for the patients with work-related spinal cord injury was 48129.15 yuan / year, accounting for 88.33% of the average annual income of the individual injured, and 56.08% of the annual income of the family. Personal income and family size had a positive impact on WTP. Conclusion When the contingent valuation method is used to estimate the economic welfare loss or the economic burden of diseases, the effects of income should be considered. Catastrophic diseases or injuries, including spinal cord injuries, may be fatal to the loss of personal economic benefits. Economic compensation has some limitations in reducing the economic welfare losses of the injured.The government should pay more attention to the management of disability, strengthen the support of social resource, promote the social work and return, reduce non market economic welfare losses caused by disability of the family, social network, social work and job change. In addition, the importance of prevention is particularly important for this catastrophic injury.