家庭层面疟疾消除阶段疟疾病例管理的经济成本分析。

Economic cost analysis of malaria case management at the household level during the malaria elimination phase in The People's Republic of China.

机构信息

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.

Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China.

出版信息

Infect Dis Poverty. 2016 Jun 3;5(1):50. doi: 10.1186/s40249-016-0141-x.

Abstract

BACKGROUND

In China, malaria has been posing a significant economic burden on households. To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of malaria elimination program in China.

METHODS

A number of study sites (eight counties in five provinces) were selected from the malaria endemic area in China, representing the different levels of malaria incidence, risk classification, economic development. A number of households with malaria cases (n = 923) were surveyed during the May to December in 2012 to collect information on malaria economic burden. Descriptive statistics were used to characterize the basic profiles of selected malaria cases in terms of their gender, age group, occupation and malaria type. The malaria economic costs were evaluated by direct and indirect costs. Comparisons were carried out by using the chi-square test (or Z-test) and the Mann-Whitney U test among malaria cases with reference to local/imported malaria patients, hospitalized/out patients, and treatment hospitals.

RESULTS

The average cost of malaria per case was 1 691.23 CNY (direct cost was 735.41 CNY and indirect cost was 955.82 CNY), which accounted for 11.1 % of a household's total income. The average costs per case for local and imported malaria were 1 087.58 CNY and 4271.93 CNY, respectively. The average cost of a malaria patient being diagnosed and treated in a hospital at the county level or above (3 975.43 CNY) was 4.23 times higher than that of malaria patient being diagnosed and treated at a village or township hospital (938.80 CNY).

CONCLUSION

This study found that malaria has been posing a significant economic burden on households in terms of direct and indirect costs. There is a need to improve the effectiveness of interventions in order to reduce the impact costs of malaria, especially of imported infections, in order to eliminate the disease in China.

摘要

背景

在中国,疟疾给家庭带来了沉重的经济负担。评估疟疾的直接和间接经济负担对于提高中国消除疟疾规划的效果具有重要意义。

方法

从中国疟疾流行地区中选取了 8 个省的 8 个县作为研究点,这些研究点代表了不同的疟疾发病率、风险分类和经济发展水平。于 2012 年 5 月至 12 月期间,对 923 例疟疾病例家庭进行了调查,收集疟疾经济负担的相关信息。采用描述性统计方法对疟疾病例的基本特征进行分析,包括性别、年龄组、职业和疟疾类型。通过直接成本和间接成本评估疟疾的经济成本。采用卡方检验(或 Z 检验)和 Mann-Whitney U 检验对本地/输入性疟疾病例、住院/门诊病例以及治疗医院进行比较。

结果

每例疟疾的平均费用为 1691.23 元人民币(直接费用为 735.41 元人民币,间接费用为 955.82 元人民币),占家庭总收入的 11.1%。本地和输入性疟疾病例的平均费用分别为 1087.58 元和 4271.93 元人民币。在县级或以上医院进行诊断和治疗的疟疾病例(3975.43 元人民币)的平均费用是在乡村或乡镇医院进行诊断和治疗的疟疾病例(938.80 元人民币)的 4.23 倍。

结论

本研究发现,疟疾直接和间接费用都给家庭带来了沉重的经济负担。需要提高干预措施的效果,以降低疟疾的影响成本,特别是输入性感染的影响成本,从而在中国消除疟疾。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ac5/4891900/4c5c50bc4874/40249_2016_141_Fig1_HTML.jpg

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