2018年埃塞俄比亚西北部贡德尔大学综合专科医院高血压疾病成本及相关因素研究
The Cost of Illness of Hypertension and Associated Factors at the University of Gondar Comprehensive Specialized Hospital Northwest Ethiopia, 2018.
作者信息
Adane Elsabet, Atnafu Asmamaw, Aschalew Andualem Yalew
机构信息
University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
Clinicoecon Outcomes Res. 2020 Mar 6;12:133-140. doi: 10.2147/CEOR.S234674. eCollection 2020.
PURPOSE
Non-communicable diseases impose a significant social, economic and health burden. Hypertension, the leading contributor to the global burden of disease and a growing public health problem worldwide, is one of the most serious non-communicable diseases. In Ethiopia, empirical evidence on the economic burden of hypertension is limited. Therefore, this study aimed to measure the cost of hypertension and associated factors at the University of Gondar comprehensive specialized hospital, northwest Ethiopia.
PATIENTS AND METHODS
An institution-based cross-sectional study was conducted on 442 adult hypertensive patients using a semi-structured questionnaire to estimate the direct and indirect costs of hypertension. The human capital approach was used to calculate indirect costs. A generalized linear model was fitted to identify factors associated with the cost of hypertension at a 95% confidence level and <0.05 p-value.
RESULTS
A total of 442, 56.3% female and 64.3% stage one hypertension patients were included. The total cost of hypertension was ETB 2510.32 ($91.72) ± 2152.80 (78.65) per patient per year; The direct medical and non-medical cost constituted 60.81% and 12.17% of the total cost of hypertension, respectively. Hospitalized (exp(b)=1.87, p<0.001), using multidrug (exp(b)=1.32, p<0.000), high socioeconomic status (exp(b)=1.41,p<0.000), college and above education(exp(b)= 1.35, p<0.016), government employment (exp(b)= 1.30, p<0.012), retirement (exp(b)= 0.71, p< 0.001) and co-morbidity (exp(b)= 1.20, p<0.004) were factors significantly associated with the cost of hypertension.
CONCLUSION
The total cost of illness of hypertension is high, and direct medical cost has the highest component of the total cost of illness. Hospitalization, using multidrug, co-morbidity, attending college and above education, highest socioeconomic status and government employment were factors significantly associated with the high cost of hypertension. Therefore, prevention and early detection of complications and co-morbidity are essential to reduce hospitalization and the number of drugs to reduce the direct medical and indirect costs.
目的
非传染性疾病带来了巨大的社会、经济和健康负担。高血压是全球疾病负担的主要促成因素，也是全球日益严重的公共卫生问题，是最严重的非传染性疾病之一。在埃塞俄比亚，关于高血压经济负担的实证证据有限。因此，本研究旨在评估埃塞俄比亚西北部贡德尔大学综合专科医院高血压的成本及相关因素。
患者与方法
采用半结构化问卷对442例成年高血压患者进行基于机构的横断面研究，以估算高血压的直接和间接成本。采用人力资本法计算间接成本。拟合广义线性模型，以确定在95%置信水平和p值<0.05时与高血压成本相关的因素。
结果
共纳入442例患者，其中女性占56.3%，一期高血压患者占64.3%。高血压的总成本为每位患者每年2510.32埃塞俄比亚比尔（91.72美元）±2152.80（78.65美元）；直接医疗成本和非医疗成本分别占高血压总成本的60.81%和12.17%。住院（exp(b)=1.87，p<0.001）、使用多种药物（exp(b)=1.32，p<0.000）、高社会经济地位（exp(b)=1.41，p<0.000）、大专及以上学历（exp(b)=1.35，p<0.016）、政府工作（exp(b)=1.30，p<0.012）、退休（exp(b)=0.71，p<0.001）和合并症（exp(b)=1.20，p<0.004）是与高血压成本显著相关的因素。
结论
高血压的疾病总成本很高，直接医疗成本在疾病总成本中占比最高。住院、使用多种药物、合并症、大专及以上学历、高社会经济地位和政府工作是与高血压高成本显著相关的因素。因此，预防和早期发现并发症及合并症对于减少住院次数和药物使用数量以降低直接医疗和间接成本至关重要。
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