School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China.
Nanjing Stomatological Hospital, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
Front Public Health. 2021 Mar 12;9:656104. doi: 10.3389/fpubh.2021.656104. eCollection 2021.
The dependence of patients with chronic diseases on drugs may affect their health-related quality of life (HRQoL). This study aims to assess the relationship between the direct economic burden caused by out-of-pocket (OOP) payments, drug accessibility, sociodemographic characteristics, and health-related quality of life. 1,055 patients with chronic diseases from Gansu, Hebei, Sichuan, Zhejiang, and Tianjin were investigated. Data collection included basic conditions and economic and health insurance conditions of patients with chronic diseases. The CLAD and Tobit regression models were used to analyze and compare the health-related quality of life and influencing factors of patients with chronic diseases in five districts. Differentiated analysis was conducted through sub-sample regression to explore the variable health effects of patients with single and multiple diseases. A total of 1,055 patients with chronic diseases participated in the study, 54.4% of whom were women. The overall average utility score was 0.727, of which Sichuan Province was the highest with 0.751. Participants reported the highest proportion of pain/discomfort problems, while patients reported the least problems with self-care. The improvement of drug accessibility and the reduction of the burden of out-of-pocket expenses have significant positive effects on HRQoL. Various sociodemographic factors such as age and gender also have significant impact on HRQoL of patients with chronic diseases. HRQoL of patients with multiple chronic diseases is more affected by various influencing factors than that of patients with single disease. In order to improve the quality of life of patients with chronic diseases, it is of great importance to ensure the accessibility of drugs and reduce patients' medication burden. Future focus should shift from preventing and controlling chronic diseases as individual diseases to meeting the comprehensive health needs of people suffering from multiple diseases.
慢性病患者对药物的依赖可能会影响其健康相关生活质量（HRQoL）。本研究旨在评估自付（OOP）支出造成的直接经济负担、药物可及性、社会人口特征与健康相关生活质量之间的关系。本研究调查了来自甘肃、河北、四川、浙江和天津的 1055 名慢性病患者。数据收集包括慢性病患者的基本情况、经济和健康保险状况。采用 CLAD 和 Tobit 回归模型分析比较了五个地区慢性病患者的健康相关生活质量及其影响因素。通过亚样本回归进行差异化分析，探讨了单一和多种疾病患者的变量健康效应。共有 1055 名慢性病患者参与了本研究，其中 54.4%为女性。总体平均效用评分为 0.727，其中四川省得分最高，为 0.751。参与者报告的疼痛/不适问题比例最高，而自我护理问题比例最低。药物可及性的提高和自付费用负担的减轻对 HRQoL 有显著的积极影响。各种社会人口因素，如年龄和性别，也对慢性病患者的 HRQoL 有显著影响。患有多种慢性病的患者的 HRQoL 比患有单一疾病的患者受各种影响因素的影响更大。为了提高慢性病患者的生活质量，确保药物的可及性和减轻患者的用药负担至关重要。未来的重点应从预防和控制作为单一疾病的慢性病转移到满足患有多种疾病的人群的全面健康需求。
