不同方式调查尘肺病患者的基本情况和就医现状

The basic characteristics and medical status of pneumoconiosis patients under different investigation methods

目的调查我国尘肺病患者的基本特征及就医现状。方法于2017年3月至2018年1月,在浙江省、江苏省、山东省等9个省采取分层抽样调查和典型调查相结合的方法,开展问卷调查,尘肺病例来源分别为入户调查病例、门诊或体检筛查病例和住院病例,主要调查尘肺病患者的人口社会学特征、经济状况、职业史、接尘史、患病状况、工伤保险和社会保障情况等内容。结果共调查1 037例尘肺病患者,其中入户调查病例186例(17.9%),门诊或体检筛查病例212例(20.4%),住院病例639例(61.7%)。不同方式调查尘肺病患者的人口社会学特征、个人月收入、经济来源、职业史及工伤保险等分布差异均有统计学意义(P<0.05)。入户调查病例中无收入患者74例(40.2%),在私营企业工作117例(62.9%),工伤保险参保36例(19.4%),叁期尘肺患者95例(51.1%),调查时未使用任何尘肺病治疗药物108例(59.0%),未去过门诊就医65例(39.4%),应住院未住院53例(28.5%)。门诊或体检筛查病例中无收入患者95例(46.1%),工伤保险参保36例(17.0%),通过门诊就医治疗尘肺病139例(65.6%),门诊次数≥10次81例(38.2%)。住院病例个人月收入≥2 000元310例(49.3%),工伤保险参保352例(55.1%),调查时正在使用尘肺病治疗药物588例(92.2%),住院>10次153例(24.2%)。结论尘肺病入户调查病例经济状况差,工伤保险参保比例低,尘肺病病情较严重,医疗服务利用不足;门诊或体检筛查病例经济状况差,工伤保险参保比例低,门诊服务利用率高;住院病例整体经济状况较好,工伤保险参保比例高,住院服务利用率较高。

Objective To analyze the characteristics of pneumoconiosis patients and the basic status of medical treatment. Methods Research objects were chosen by stratified sampling method and typical survey method from existing pneumoconiosis patients in China. The survey was carried out from March 2017 to January 2018 in nine provinces including provinces from east, medium and western region in China. Source of pneumoconiosis cases were inpatient cases, outpatient or physical-examined cases and household-investigation cases. The survey mainly included demographic and sociological characteristics, economic status, occupational history and dust exposure history, disease status, work-related injury insurance and social security status and related indicators of pneumoconiosis treatment. Results Investigated 1037 pneumoconiosis cases which included 186 (19.9%) household-investigation cases, 212 (20.4%) outpatient or physical-examined cases and 639 (61.7%) inpatient cases. Demographic and sociological characteristics, individual monthly income, economic source, occupational history and work-related injury insurance were statistically significant among different source of pneumoconiosis patients (P<0.05). Among all of the household-investigation cases, there were 74 cases (40.2%) had no income, 117 cases (62.9%) used to work in private enterprises, 36 cases (19.4%) had work-related injuries insurance, 95 cases (51.1%) were at three phase of pneumoconiosis, 108 cases (59.0%) haven't had any drugs for pneumoconiosis. 65 cases (39.4%) haven't went to the clinic, 53 cases (28.5%) hadn't seek medical advice although they needed medical treatment very much. Among all of the outpatient or physical-examined cases, there were 95 cases (46.1%) had no income, 36 cases (17.0%) had work-related injuries Insurance, 139 cases (65.6%) went to the clinic for treatment of pneumoconiosis, 81 cases (38.2%) went to the clinic for more than ten times. Among all the inpatient cases, 310 cases'(49.3%) personal monthly income was above 2000 yuan, 352 cases (55.1%) had work-related injuries Insurance, 588 cases (92.2%) were taking drugs for treatment of pneumoconiosis, 153 canses (24.2%) had hospitalization for than ten times. Conclusion Household-investigation cases have lower economic conditions, lower rates of Insurance coverage for work-related injuries, severer pneumoconiosis and higher clinical service utilization. Clinical or physical-examined cases have lower economic conditions, lower rates of Insurance coverage for work-related injuries and higher clinical service utilization. Hospitalized cases have better economic conditions, higher rates of insurance coverage for work-related injuries and higher hospitalization service utilization.