上海市嘉定区慢性乙型肝炎患者疾病直接经济负担现状及关联因素分析

Direct economic disease burden status of chronic hepatitis B patients and its associated factors in Jiading District of Shanghai

目的调查上海市嘉定区慢性乙型肝炎患者疾病直接经济负担现状及关联因素。方法2017年1月1日—2018年12月31日在上海市嘉定区首次确诊管理的慢性乙型肝炎患者共197例,采用自行设计的基础信息调查表和疾病直接经济负担量表作为调查工具对这些患者开展调查,对调查表结果进行统计分析。结果嘉定区慢性乙型肝炎患者的年度疾病直接经济负担中位数为6000元,年度直接医疗费用占年度疾病直接经济负担的95.40%,医疗保险的报销比例为64.25%,经医疗保险报销后患者年疾病直接经济负担占患者年均收入的12.21%。自行购买药物次数、门诊诊疗次数以及住院诊疗次数是慢性乙型肝炎患者疾病经济负担的关联因素。结论慢性乙型肝炎患者更多的依赖医疗服务,直接非医疗费用较少;慢性乙肝患者的疾病直接经济负担总体不高,主要与自行购药、门诊及住院诊疗次数相关。

Objective To investigate the direct economic disease burden status of the chronic hepatitis B patients and its associated factors in Jiading District of Shanghai.Methods Totally 197 chronic hepatitis B patients who were diagnosed and managed for the first time in Jiading District from January 1,2017 to December 31,2018 were recruited in the study.The selfdesigned basic information questionnaire and direct economic disease burden questionnaire were employed to investigate the chronic hepatitis B patients,and the results were statistically analyzed.Results The median of the annual direct economic disease burden among the chronic hepatitis B patients in Jiading District was 6000 yuan.The annual direct medical expenses account for 95.40%of the annual direct economic disease burden,and the medical insurance reimbursement ratio was 64.25%.After the medical insurance was reimbursed,the annual direct medical expenses of patients accounted for 12.21%of the average annual income of patients.The number of self-purchased drugs,the number of outpatient visits and the number of inpatient visits were the associated factors which influence the direct economic disease burden of chronic hepatitis B patients.Conclusion Chronic hepatitis B patients mostly rely on medical services and the direct non-medical expenses is less.The direct economic disease burden of chronic hepatitis B patients is generally not high,mainly associated to the number of self-purchased drugs,and the number of outpatient and inpatient visits.