广州市痴呆共病患者疾病直接经济负担及影响因素分析

Analysis of the direct economic burden and influencing factors of diseases in patients with dementia comorbidity in Guangzhou

目的:分析广州市痴呆共病患者直接经济负担及其影响因素,为痴呆共病患者的经济成本测算与家庭照护负担评估提供参考依据。方法:采用自编问卷,收集广州市痴呆共病患者社会人口学特征、治疗情况、疾病直接经济负担等情况;使用Charlson查尔森合并症指数(charlson comorbidity index,CCI)评估共病负担;使用直接法估算直接经济负担费用,经正态性检验服从偏态分布,对数转换使其呈近似正态化后应用于多元线性回归模型。结果:广州市痴呆共病患者过去1年产生的人均直接经济负担费用为7180.00(3600.00,15568.67)元,其中人均直接医疗费用为6150.00(3185.00,12590.00)元,人均直接非医疗费用为0.00(0.00,2082.50);CCI共病负担指数为5.00(5.00,6.00),共病负担与直接经济负担均较重。多元线性回归结果显示疾病直接经济负担的主要影响因素为患者所在区域、就诊地点、合并慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)或老年慢性支气管炎、合并心脏病及服用痴呆药物种类。结论:广州市痴呆共病患者直接经济负担较重,影响因素具有多维度与复杂性的特征,需要政府、社会和医疗机构等多方面共同努力与探索。

Objective:To analyze the direct economic burden of patients with dementia comorbidities and its influencing factors,and to provides a reference basis for economic cost calculation and family care burden assessment in patients with comorbid dementia.Methods:Using a self-designed questionnaire,the sociodemographic characteristics,treatment status,and direct economic burden of dementia comorbid patients in Guangzhou were collected.The Charlson Comorbidity Index(CCI)was used to assess the comorbidity burden.The direct economic burden costs were estimated using the direct method,and after a normality test showed a skewed distribution,logarithmic transformation was applied to approximate normalization before using it in a multiple linear regression model.Results:The per capita direct economic burden of dementia patients in Guangzhou in the past year was 7180.00(3600.00,15568.67)yuan,of which the per capita direct medical cost was 6150.00(3185.00,12590.00)yuan.The per capita direct non-medical cost was 0.00(0.00,2082.50)yuan,and Charlson Comorbidity Index(CCI)was 5.00(5.00,6.00),indicating a heavy comorbidity burden as well as a significant direct economic burden.The results of the multiple linear regression analysis showed that the primary factors influencing the direct economic burden of the disease were the patient's region,place of treatment,comorbid Chronic Obstructive Pulmonary Disease(COPD)or senile chronic bronchitis,comorbid heart disease,and types of dementia medications taken.Conclusion:The direct economic burden of dementia comorbid patients in Guangzhou is heavy,and the influencing factors are multi-dimensional and complex,which requires the joint efforts and complex,which requires the joint efforts and exploration of the government,society and medical institutions.