西安市阿尔茨海默病经济负担调查及影响因素分析

Investigation on the economic burden and its influencing factors of Alzheimer's disease in Xi'an

目的调查西安市阿尔茨海默病(AD)病人的经济负担,分析其影响因素。方法对119例AD病人及其照料者进行问卷调查,包括基本信息、直接医疗费用、直接非医疗费用等。结果 AD病人平均每月直接医疗总费用中位数为1318元,直接非医疗总费用中位数为800元。单因素分析显示,农村和文盲病人直接医疗总费用低于城市和其他文化水平病人(P=0. 012,0. 018),年龄<60岁和重度AD病人直接非医疗总费用高于其他年龄组和轻、中度病人(P=0. 004,0. 013)。多因素线性回归分析提示,直接医疗总费用受居住地(B=-755. 042,P=0. 001)和发病年龄(B=-21. 436,P=0. 033)的影响,直接非医疗总费用受AD病情严重程度(B=-121. 195,P=0. 000)和居住地(B=-1222. 117,P=0. 004)的影响。结论 AD病人直接医疗费用、直接非医疗费用、间接负担均沉重,发病年龄、长期居住地及AD病情严重程度是影响其经济负担的主要因素。

Objective To investigate the economic burden of patients with Alzheimer's disease (AD) in Xi'an and to analyze the related influencing factors.Methods A total of 119 AD patients and their caregivers were interviewed by face-to-face questionnaire, including basic information of patients and carers, direct medical expenses, direct non-medical expenses and indirect costs.Results Among the 119 patients, the median total monthly direct medical costs were 1318 yuan and the median total direct non-medical costs were 800 yuan. Univariate analysis showed that the total direct medical costs in rural and the illiteracy patients were significantly lower than those in city or with the other educational level respectively ( P = 0.012, P = 0.018). The total direct non-medical costs in patients younger than 60 years or the patients with severe AD were lowest( P = 0.004, P = 0.013). Multivariate linear regression showed that the place of residence ( B =-755.042, P = 0.001) and onset age( B =-21.436, P = 0.033) were the significant influencing factors for total direct medical costs, and the severity of AD ( B =-121.195 , P = 0.000) and residence ( B =-1222.117, P = 0.004) were the significant influencing factors for total non-medical costs.Conclusions The direct medical costs, direct non-medical cost and indirect burden are all serious in AD patients. The onset age, residence and severity of AD are the main factors affecting the economic burden.