华东地区眼部化学烧伤患者医疗支出与社会经济地位分析：一项回顾性研究。
Analysis of medical expenditure and socio-economic status in patients with ocular chemical burns in East China: a retrospective study.
机构信息
Department of Ophthalmology, Eye & ENT Hospital of Fudan University, No, 83 Fenyang Road, Shanghai 200031, China.
出版信息
BMC Public Health. 2012 Jun 6;12:409. doi: 10.1186/1471-2458-12-409.
BACKGROUND
Little has been known regarding the relationship between ocular chemical injury and victims' medical expenditure, income loss and socio-economic status changes. So we conduct this retrospective cross-sectional study in patients with ocular chemical burns in East China.
METHODS
Fifty-six patients were enrolled and required to complete a self-report questionnaire consisting of the following contents: entire expenditure on medical treatment; the victims' personal and household per capita income, and income loss caused by the injury; and the changes of socioeconomic status as well.
RESULTS
The median expense of medical treatment was CNY 40,000 (approximately US$5,900). The medical expenditure rose significantly with increased injury severity, prolonged hospital stay, and increased frequency of surgery. More than half victims (51.8 %, 29/56) paid all or the majority of medical expense by themselves. The expense of only 5 victims was mainly paid by medical insurance, accounting for less than ten percent (8.9 %, 5/56). The victims' personal and household per capita income both decreased significantly after the injury, with the median reduction being CNY 24,000 and CNY 7,800 (approximately US$3600 and US$1200) per year respectively. The reduction amplitude of personal and household per capita income rose with increased injury severity and prolonged time of care required. The injury caused emotional depression or anxiety in 76.8 % (43/56) victims, and the relationship with their relatives got worse in 51.9 % (29/56) patients. Moreover, only 21.4 % (12/56) patients felt that the whole society gave them care and concern after the injury, whereas 46.4 % (26/56) and 28.6 % (16/56) felt indifference or discrimination from society as a whole (X2 = 16.916, P = 0.028).
CONCLUSIONS
The medical expense was a huge economic burden to most victims of ocular chemical burns, and personal and household per capita income of the victims decreased significantly after injury, both of which had a close relationship with the injury severity. Formal legislation was urgently needed to compel the employer to purchase injury or medical insurance and provide more compulsory protection to the population working in high risk occupations. In addition, psychological counseling and instruction shouldn't be neglected in the aid and treatment of victims.
背景
眼部化学伤与受害者的医疗支出、收入损失和社会经济地位变化之间的关系鲜为人知。因此，我们在华东地区进行了这项回顾性横断面研究。
方法
共纳入 56 例眼部化学烧伤患者，需完成一份自我报告问卷，内容包括：医疗总费用；患者个人和家庭人均收入，以及因伤导致的收入损失；以及社会经济地位的变化。
结果
医疗费用中位数为 40,000 元人民币（约合 5,900 美元）。医疗费用随损伤严重程度增加、住院时间延长和手术次数增加而显著增加。超过一半的患者（51.8%，29/56）自行支付了全部或大部分医疗费用。仅 5 名患者的费用主要由医疗保险支付，不到 10%（8.9%，5/56）。受伤后，患者个人和家庭人均收入均显著下降，中位数分别减少 24,000 元和 7,800 元人民币（约合 3600 美元和 1200 美元）。个人和家庭人均收入减少幅度随损伤严重程度增加和护理时间延长而增加。76.8%（43/56）的患者受伤后出现情绪抑郁或焦虑，51.9%（29/56）的患者与亲属关系恶化。此外，仅有 21.4%（12/56）的患者受伤后感到整个社会对他们的关心和关注，而 46.4%（26/56）和 28.6%（16/56）的患者则感到整个社会对他们漠不关心或歧视（X2=16.916，P=0.028）。
结论
医疗费用是大多数眼部化学烧伤患者的巨大经济负担，受伤后患者个人和家庭人均收入显著下降，两者均与损伤严重程度密切相关。迫切需要制定正式立法，强制雇主购买伤害或医疗保险，并为从事高风险职业的人群提供更多强制性保护。此外，在对受害者的援助和治疗中，不应忽视心理咨询和指导。
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