江苏省糖尿病患者疾病经济负担实证研究

An Empirical Study on the Economic Burden of Diabetes in Jiangsu Province

目的掌握江苏省糖尿病患者疾病经济负担状况,为进一步控制糖尿病患者医疗费用、减轻糖尿病患者经济负担和优化糖尿病健康管理策略提供实证依据。方法在江苏省苏南、苏中和苏北6县(市、区)开展糖尿病患者问卷调查,共计2 444例患者纳入分析,测算患者直接经济负担、间接经济负担、无形经济负担和总疾病经济负担,采用方差分析比较不同合并症与并发症数量间糖尿病患者的疾病经济负担差异。结果调查前一年,调查对象的人均直接经济负担为3 566元,其中药品费用占比达到64.7%,间接经济负担为737元,无形经济负担为3 783元,总疾病经济负担为8 086元。江苏省糖尿病患者的年总疾病经济负担为271.0亿元。随着并发症数量的增加,糖尿病患者的疾病经济负担也呈明显上升趋势。结论江苏省糖尿病患者无形经济负担较重,药品费用是直接经济负担的主要来源,并发症是造成患者疾病经济负担的主要因素。应当重视对糖尿病患者生命质量的动态评价,积极开展个性化健康干预指导,落实以家庭医生签约服务为抓手的分级诊疗制度建设,加强对糖尿病的早诊断和早治疗,从而预防并发症的发生,减轻糖尿病患者的疾病经济负担。

OBJECTIVE To understand the economic burden of diabetic patients in Jiangsu Province in order to provide evidence for further controlling the medical expenses, reducing the economic burden of diabetic patients and optimizing the strategy for diabetes health management. METHODS A total of 2 444 diabetic patients were investigated by a questionnaire administered in 6 counties(cities and districts) of southern, central and northern Jiangsu Province. The direct, indirect, intangible economic burden and total disease economic burden were calculated. ANOVA was used to examine the difference in the disease economic burden between diabetic patients with different number of comorbidities and complications. RESULTS The direct economic burden per capita was 3 566 yuan in the year before the survey, of which medication fees accounted for 64.7%, the indirect economic burden was 737 yuan, the intangible economic burden was 3 783 yuan, and the total disease economic burden was 8 086 yuan. The annual total economic burden of diabetic patients in Jiangsu Province was 27.1 billion yuan. With the increase of the number of complications, the economic burden of diabetic patients was also on the rise. CONCLUSION The intangible economic burden of diabetic patients in Jiangsu Province was heavy.Medication fees were the main source of direct economic burden, and complications were the main factors causing the economic burden of diabetic patients. It needed to value the dynamic evaluation of the quality of life of diabetic patients, actively carry out individualized health intervention and guidance, implement the tiered system of diagnosis and treatment with contracted services provided by family doctors as the principal domain, and strengthen the early diagnosis and treatment of diabetes, so as to prevent complications and reduce the economic burden of diabetic patients.