Zhang Ben, Zhang Yuan, Yang Jiyun, Liu Xiaoqi
Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
Wei Sheng Yan Jiu. 2007 Nov;36(6):706-10.
To describe direct economic burden of chronic obstructive pulmonary disease (COPD) patients and its influence factors in the communities of Chengdu City.
446 patients in 6 communities where community health service was trialed were selected by random clustering sampling as study object. Each patient was interviewed in their home by using a self-designed questionnaire, and medical records were abstracted as an assistant means. The main items involved in the questionnaire included general social and demographic characteristics, COPD related contents and attitude to COPD, as well as direct economic burden and average income in the past years.
(1) The median of annual direct economic burden was 1280 Yuan for each community COPD patient. There were no significant differences between male and female patients, and among various age groups. The median of annual direct economic burden of first episode COPD was 1540 Yuan for each patient, and that of COPD was 1090 Yuan for each chronic patient. The annual direct economic burden of first episode was significantly higher than that of chronic patients (P < 0.05). The costs of out-patient, hospitalization, accommodation of hospitalization and treatment at home of middle-aged patients were significant higher than that of old-aged patients (P < 0.05), and that of long-term self-expended drugs were significant lower than that of old-aged patients (P < 0.05). (2) The annual general medical cost of hospitalization, outpatient, and long-term self-expended drugs of community COPD patients were equal to 91.77% of annual general medical cost of all patients. The proportion of annual general medical cost of all patients in winter among the whole year was 50.17%. (3) The main influence factors of medical cost fur COPD patients were hospitalization visits, disease condition, attitude to COPD, occupation and the pattern of medical burden.
The direct economic burden of community COPD patients was heavy in Chengdu, which embodied in that the medical costs were close to 1/4 of average annual income of investigating population. Therefore, measures need to be made by our nation and the influence factors should be intervened so that the direct economic burden of community COPD patients will be decreased in this city.
描述成都市社区慢性阻塞性肺疾病(COPD)患者的直接经济负担及其影响因素。
采用随机整群抽样方法,选取6个试行社区卫生服务的社区中的446例患者作为研究对象。通过自行设计的问卷对每位患者进行入户访谈,并辅以病历资料摘录。问卷涉及的主要内容包括一般社会人口学特征、COPD相关内容及对COPD的态度,以及过去几年的直接经济负担和平均收入。
(1)各社区COPD患者年直接经济负担中位数为1280元。男女患者及各年龄组之间差异无统计学意义。初发COPD患者年直接经济负担中位数为1540元/例,慢性COPD患者为1090元/例。初发患者的年直接经济负担显著高于慢性患者(P<0.05)。中年患者的门诊、住院、住院食宿及居家治疗费用显著高于老年患者(P<0.05),长期自购药品费用显著低于老年患者(P<0.05)。(2)社区COPD患者年住院、门诊及长期自购药品的总医疗费用占所有患者年总医疗费用的91.77%。全年所有患者冬季的年总医疗费用占比为50.17%。(3)COPD患者医疗费用的主要影响因素为住院次数、病情、对COPD的态度、职业及医疗负担方式。
成都市社区COPD患者直接经济负担较重,体现为医疗费用接近被调查人群年平均收入的1/4。因此,国家应采取措施,干预影响因素,以降低该市社区COPD患者的直接经济负担。