上海糖尿病患者经济负担的深度访谈报告

Economic Burden of Diabetes in Shanghai:an in-depth interview report

为了解上海糖尿病患者的经济负担,本研究选取了上海8个社区卫生服务中心的120例糖尿病患者,由培训后的医护人员采用半结构化的糖尿病脆弱性评估问卷对其进行录音访谈和转录,并使用NVivo10.0软件对访谈内容进行编码及资料分析。受访者反映的主要经济负担有:糖尿病日常支出费用较高,并随病程延长及并发症的出现而进一步增多;医保个人自付比例较高,对诊疗花费的覆盖比例因医院等级而异,一些常规用药不在医保报销范围内;失业进一步影响了糖尿病患者对经济负担的承受能力。本研究为合理配置我国糖尿病患者的医疗卫生资源提供了新的思路。

120 willing diabetic patients（65 males and 55 females）,who had medical files across eight Community Health Centers in Shanghai（four centers in urban regions and four centers in rural regions）,were enrolled in this study to investigate the economic burden of diabetes.The doctors and nurses of each center were trained to interview about 15 interviewees using a semi-structured diabetes vulnerability assessment questionnaire.Interviews were recorded digitally and transcribed verbatim.Qualitative data were coded and analyzed by using NVivo 10.0.The main questions regarding the financial burdens of diabetes covered the following aspects：（1）expenditure on diabetes were high and became heavier with the presence of complications,the longer duration of diabetes they had,the more the expenditure,（2）coverage ratio of existing health insurance was low and varied by hospital type,and even some commonly used medicines were not covered by health insurance,（3）unemployment further aggravated these burdens.With a lack of economic security and incomplete coverage from health insurance,treatment became an economic burden on the majority of these interviewees.The study provided cut-edge views and methods for exploring the economic burden of diabetes in cities and helped in understanding how to rationally allocate medical and health resources in patients with diabetes in Shanghai.