北京市成年流感样病例就诊行为及其经济负担研究

Medical-seeking behaviors and economic burden of adult influenza-like illness cases in Beijing

目的分析北京市成年流感样病例的就诊行为及其经济负担。方法于2013年12月6日至2014年1月16日,在北京市采用多阶段抽样方法,抽取150个村(居委会)共7354名北京市成年居民作为调查对象,通过匿名自填问卷进行横断面研究,内容包括人口学特征、过去2周内流感样病例发生情况、流感样病例就诊行为及其经济负担。结果共收回有效问卷7327份。过去2周内,流感样症状罹患率为6.9%(506/7327)。在498例回答了就诊信息的流感样病例中,345例就诊于各类医疗机构,就诊率为69.3%,其中二级以上医疗机构、社区卫生服务中心就诊率分别为27.9%(139/498)和39.6%(197/498)。平均总费用为(523.2±2355.4)元,其中未就诊、门诊和住院病例的总费用分别为(167.9±495.3)元、(463.8±750.3)元和(25768±17276.9)元,三组病例间差异有统计学意义(P<0.01)。结论流感样病例可以导致严重医疗负担,了解就诊行为及其经济负担可为开展流感疾病负担研究提供基础资料。

Objective To identify medical-seeking behaviors and related economic burden of adult influenza-like illness (ILI) cases. Methods From December 6, 2013 to January 16, 2014, 7 354 adult residents in 150 villages or communities in Beijing were selected as survey subjects using a multistage sampling method. A cross-sectional study was carried out with self-administered anonymous questionnaires. The questionnaire consisted of demographic information, self-reported influenza-like syndromes in the past two weeks, medical-seeking behaviors and related economic burden. Results A total of 7 327 effective questionnaires were retrieved. The attack rate of ILI during the past two weeks was 6.9%(506/7 327). Among the 498 ILI patients who answered the questions of medical-seeking behaviors, 345 (69.3%) visited medical institutions. The hospital visit rates in secondary and above hospitals and in community health service centers were 27.9%(139/498) and 39.6%(197/498), respectively. The average total cost was 523.2±2 355.4 Yuan. The total costs of those who didn’t seek medical services, visit outpatients and hospitalized cases were 167.9±495.3 Yuan, 463.8±750.3 Yuan and 25 768±17 276.9 Yuan, respectively. The difference was statistically significant among the three groups (P<0.01). Conclusions Influenza-like illness can lead to serious medical burden. Understanding medical-seeking behaviors and related economic burden can provide the basic parameters for carrying out research on the burden of influenza.