Ma Yunyan, Yu Hang, Sun Hongbing, Li Mi, Li Li, Qin Meng
Blood Purification Room of Nephrology Department, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Ministry of Cadre Health Care, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Ann Palliat Med. 2020 Nov;9(6):3877-3884. doi: 10.21037/apm-20-1787. Epub 2020 Nov 6.
Maintenance hemodialysis is the main therapy for clinical treatment of end-stage renal disease (ESRD). The aim of this study was to analyze the current status of the economic burden levied on families with members who are maintenance hemodialysis patients in Nanchong, and the related influencing factors.
A total of 111 patients with ESRD who were admitted to our hospital from April 2018 to April 2020 and treated with maintenance hemodialysis were selected as research subjects. A questionnaire survey was adopted as a data collection and interview method to observe the economic burden of families with a member who was a maintenance hemodialysis patient. Logistic regression analysis was used to analyze the independent risk factors that affect this economic burden.
The direct economic burden, indirect economic burden, and average annual total economic burden (the sum of the direct economic burden and indirect economic burden of hemodialysis patients) of patients in the resident medical insurance group were significantly higher than those in the employee medical insurance group, resident medical insurance + poverty relief group, and employee medical insurance + poverty relief group (P<0.05). The analysis of the unconditional multifactor logistic regression model showed that age, occupation, monthly family income, and medical insurance type were independent risk factors that affected the average annual total economic burden of patients with maintenance hemodialysis (P<0.01).
Various medical insurance systems can effectively reduce the economic burden of hemodialysis patients, but patients must still bear significant financial hardship. It is necessary to further improve the medical insurance for patients with hemodialysis and increase management efforts to popularize the poverty relief policy.
维持性血液透析是终末期肾病(ESRD)临床治疗的主要手段。本研究旨在分析南充市维持性血液透析患者家庭经济负担的现状及其相关影响因素。
选取2018年4月至2020年4月在我院收治的111例接受维持性血液透析治疗的ESRD患者作为研究对象。采用问卷调查作为数据收集和访谈方法,观察维持性血液透析患者家庭的经济负担。采用Logistic回归分析影响该经济负担的独立危险因素。
居民医保组患者的直接经济负担、间接经济负担及年均总经济负担(血液透析患者直接经济负担与间接经济负担之和)显著高于职工医保组、居民医保+扶贫组和职工医保+扶贫组(P<0.05)。无条件多因素Logistic回归模型分析显示,年龄、职业、家庭月收入和医保类型是影响维持性血液透析患者年均总经济负担的独立危险因素(P<0.01)。
各种医保制度可有效减轻血液透析患者的经济负担,但患者仍需承受巨大的经济困难。有必要进一步完善血液透析患者医保制度,加大管理力度,推广扶贫政策。