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中国西南农村地区 2 型糖尿病经济负担和灾难性医疗费用的短期趋势。

Short-Term Trends in Economic Burden and Catastrophic Costs of Type 2 Diabetes Mellitus in Rural Southwest China.

机构信息

School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming 650500, China.

The First Affiliated Hospital of Kunming Medical University, Renmin Western Road, Kunming, China.

出版信息

J Diabetes Res. 2019 Aug 1;2019:9626413. doi: 10.1155/2019/9626413. eCollection 2019.

Abstract

OBJECTIVES

This study is aimed at gaining insights on the changing prevalence, economic burden, and catastrophic costs of diabetes in rural southwest China.

MATERIALS AND METHODS

Data were collected from two cross-sectional health interviews and examination surveys among individuals aged ≥ 35 years in rural Yunnan Province. A prevalence-based cost-of-illness method was used to estimate the cost of diabetes. Information about the participants' demographic characteristics and economic consequences of diabetes was obtained using a standard questionnaire. Fasting blood sugar levels were recorded for each study participant.

RESULTS

During the study period, the overall prevalence of diabetes increased from 7.7% to 9.5% ( < 0.01) and the economic cost of diabetes increased 1.52-fold. The largest increases were observed in hospital costs (1.77-fold increase), while unit medication costs fell by 18.6%. Both in 2009 and in 2016, males had higher overall direct and indirect costs of diabetes than females ( < 0.05). Direct costs represented the largest component of economic cost of diabetes while hospital costs were the main drivers of direct medical expenditures, accounting for 66.2% of the total direct costs in 2009 and 75.9% in 2016. The incidence of household catastrophic health payment and household impoverishment due to diabetes was 24.0% and 17.9% in 2009 and 23.6% and 17.6% in 2016, respectively. These rates did not differ between the two survey years ( > 0.05).

CONCLUSIONS

The prevalence and economic burden of diabetes increased substantially from 2009 to 2016 in rural southwest China. The findings underscore an urgent need for the government to invest more financial resources in the prevention of diabetes and improvement of access to affordable medication in rural southwest China.

摘要

目的

本研究旨在深入了解中国西南农村地区糖尿病流行率、经济负担和灾难性医疗费用的变化情况。

材料与方法

数据来自云南省农村地区两次 35 岁及以上人群的横断面健康访谈和体检调查。采用基于患病率的疾病成本法估算糖尿病的医疗费用。使用标准问卷获取参与者的人口统计学特征和糖尿病经济后果信息。为每位研究参与者记录空腹血糖水平。

结果

研究期间,糖尿病总体患病率从 7.7%上升至 9.5%(<0.01),糖尿病经济负担增加了 1.52 倍。其中,医院费用增长最大(增长 1.77 倍),而单位药物费用下降 18.6%。2009 年和 2016 年,男性糖尿病总直接和间接费用均高于女性(<0.05)。直接费用占糖尿病经济负担的最大组成部分,而医院费用是直接医疗支出的主要驱动因素,2009 年和 2016 年分别占总直接费用的 66.2%和 75.9%。2009 年和 2016 年,因糖尿病导致的灾难性医疗支出和因病致贫发生率分别为 24.0%和 17.9%、23.6%和 17.6%,两个年份间差异无统计学意义(>0.05)。

结论

2009 年至 2016 年,中国西南农村地区糖尿病的流行率和经济负担显著增加。研究结果强调,政府急需在该地区投入更多财政资源,以预防糖尿病并改善农村地区患者对廉价药物的可及性。

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