深圳市宝安区严重精神障碍患者药费减免政策的效果评估

Evaluation of the effect of drug fee reduction policy for severe mental disorders in Baoan district, Shenzhen

目的探讨药费减免政策对社区严重精神障碍患者生活与治疗的影响,为政府修订和制定政策提供可靠的依据。方法选取2017年3—4月深圳市宝安区303例严重精神障碍患者实施药费减免,并于药费减免前后采用自制调查表,比较患者在服药依从性、自我感受治疗费用负担、危险度评估及病情稳定性的变化,评估药费减免对患者疾病负担的影响,评价药费减免政策的效果。结果严重精神障碍患者在药费减免1年后,服药依从性较药费减免前明显提高,差异有统计学意义(P<0.01)。自我感受治疗费用负担较前减轻,差异有统计学意义(P<0.01)。服药方式以自行服药和他人督促服药为主,药费减免前后差异无统计学意义(P>0.05)。未规律服药原因中担心服药影响智力或认为取药不方便人数较前均有所下降,但差异无统计学意义(P>0.05)。药费减免1年后危险度评估分级较前明显下降,差异有统计学意义(P<0.05)。病情稳定人数较药费减免前明显增加,基本稳定和不稳定患者明显减少,差异有统计学意义(P<0.01)。结论药费减免政策能吸引患者纳入社区管理,减轻患者家庭经济负担,促进患者坚持服药,是严重精神障碍患者获得有效康复途径之一。

Objective To explore the effect of drug fee reduction policy on the disease of community patients with severe mental disorders. Methods A total of 303 patients with severe mental disorders in Baoan district of Shenzhen were recruited, and a self-made questionnaire was used before and after the drug fee reduction policy to compare the patients' compliance, the cost burden of self-feeling for treatment, risk assessment and the change of the disease stability. The effect of drug fee reduction policy on the disease burden of the patients was evaluated. Methods After 1 years of drug fee reduction, the compliance of medication was significantly higher than that before(P<0.01), and the cost burden of self-feeling for treatment was less than that before(P<0.01). There was no significant difference in the way of taking medicine by oneself and the others to urge to take the medicine(P>0.05). The degree of risk assessment was significantly lower than before(P<0.05), and the number of stable patients increased significantly(P<0.05). Conclusions The drug fee reduction policy can attract patients into community management, reduce the patients family economic burden, and promote patients adherence to medication adherence. The drug fee reduction policy is one of rehabilitative way for the patients with severe mental disorders.