支气管哮喘防治现状与对策的卫生经济学分析

A medical-economic investigation on bronchial asthma in several districts of the southwestern part of China

目的 分析西南部分地区支气管哮喘患者的预防管理和卫生经济学现状,探讨适当的防治方案和药物组合。方法 对四川、重庆、云南等地9所医院的门诊及住院患者进行问卷调查,问卷包括患者一般资料、发作诱因、合并症、家族史、发作程度与频率、客观检测与自我监测、治疗方式、用药情况、哮喘相关社会事件、哮喘相关经济学指标、接受哮喘宣教及患者对哮喘认识程度等60个问题。结果 108例患者的家庭月收入加权平均值为893.51元,而哮喘防治直接成本加权平均值为2677.77元/年,防治费用占收入24.97％。50％的患者预期费用在250～1000元/年。结论 在强调皮质激素和吸入疗法为主的预防治疗的同时,应针对不同的社会经济阶层制订个体化的防治策略。

Objective To investigate the management profiles of and economic impact on the asthmatic population in the southwestern part of China in order to explore optimal prevention strategy for different socio-economic classes. Methods With the use of a specially designed questionnaire involving 60 items, data were collected from asthmatic out-patients and in-patients at nine hospitals in Sichuan, Chongqing and Yunnan.Results The average family income monthly of 108 subjects investigated was 893.51 yuan, whereas average direct cost-of-illness for asthma was 2 677.77 yuan annually.In 50% of the subjects,the expectant cost was 250 to 1 000 yuan annually. 80% of patients perceived asthma as a financial burden to their families.Conclusion Although glucocorticoids inhalation is the mainstay of asthma management, it is essential to take affordable .cost-effective strategy for lower income population.