河南省南阳市因病致贫的病因及费用负担分析

Analysis of diseases incurring poverty and its cost burden in Nanyang city of Henan province

目的了解贫困户因病致贫的疾病类型、患病人群分布以及致贫疾病对贫困户造成的经济负担。方法于2017年8月17—24日，采用基于App调查问卷现场获取数据的方式，对河南省南阳市7个贫困县2824户贫困户进行调查，了解致贫疾病对患者劳动能力的影响及其费用负担。采用描述性统计、秩和检验及相关性分析等分析数据。结果61．79％（1745户）的贫困户是因病致贫，40～60岁的居民是主要的患病群体。脑血管疾病、恶性肿瘤、缺血性心脏病、精神疾病等10种疾病是最重要的致贫疾病，其在较大程度上对患者劳动能力造成了损害，其中完全失能者达37．67％。患者年自付费用占年总费用比高达57．22％。结论应调整医保政策，切实提高医疗补偿范围和力度；提高公共卫生服务水平，积极开展健康促进和健康教育工作；强化政府督导考核，不断减轻患者疾病负担。

Objective To investigate the disease types incurring poverty, patient population layout, and cost burden by poor households due to illness. Methods During the time August 17 -24,2017, App questionnaires were used onsite for data survey at 2 824 poor hourseholds in Nanyang city of Henan province, in order to learn the impacts of the poverty-causing diseases on the labor capacity of the patients and the cost burdens. Such methods as descriptive analysis, rank sum test and correlation analysis were used for data analysis. Results The survey found that 61.79 percent （ 1 745 households ） of the poor households turned poor by illness, most of them aged 40 to 60 years old. The ten disease categories, namely cerebrovascular diseases, malignant tumor, ischemic heart diseases and mental diseases, constitute top disease causes of poverty. These diseases significantly damage their labor capacity, up to 37.67% of them totally disabled. The self-paid expenses of the patients per year accounted for 57.22% of the total annual expenses. Conclusions Medical insurance policies need to elevate the scope and efforts of medical compensation; public health services need to improve health promotion and health education; government supervision needs to be enhanced to keep minimizing patients＇ disease burdens.