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中国多地区住院毛细支气管炎或肺炎患儿的经济负担及影响因素研究。

Economic burden and influence factors among hospitalized children with bronchiolitis or pneumonia: a multiregional study in China.

机构信息

School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.

School of Public Health, Fudan University, Shanghai, China.

出版信息

Front Public Health. 2024 Sep 2;12:1364854. doi: 10.3389/fpubh.2024.1364854. eCollection 2024.

Abstract

BACKGROUND

Bronchiolitis and pneumonia are both significant lower respiratory tract infections with a profound impact on children's health. The purpose of this study is to explore the economic burden and related influence factors of pediatric patients with bronchiolitis and pneumonia in China.

METHODS

A face-to-face interview was employed for the investigation of hospitalized patients (≤5 years old) with bronchiolitis and pneumonia, along with their guardians from January to October 2019. Demographic and costs were collected from Shanghai, Zhengzhou, and Kunming, representing three regions with different levels of economic development in China. Multiple linear regression analysis was used to explore factors associated with the economic burden of the diseases.

RESULTS

A total of 338 patients with bronchiolitis and 529 patients with pneumonia were included in the analysis. The average hospitalization and total cost for patients with bronchiolitis are 4,162 CNY and 5,748 CNY, respectively, while those with pneumonia are 6,096 CNY and 7,783 CNY. Patients from Shanghai, both bronchiolitis and pneumonia, exhibited the lowest cost expenditures, with average total costs of 3,531 CNY and 3,488 CNY, respectively. Multiple regression analysis indicated that, among bronchiolitis patients, factors such as region, medical insurance, relationship, loss of work time, and length of stay were found to be significantly associated with both hospitalization cost and total cost ( < 0.05). For pneumonia patients, the hospitalization cost and total cost were significantly impacted by region, medical insurance, and length of stay ( < 0.05).

CONCLUSION

Bronchiolitis and pneumonia in children put substantial economic burden on families of affected children. The financial strain varies significantly across different regions, with families in underdeveloped areas and those dealing with pneumonia facing particularly daunting challenges. Targeted policies to reduce healthcare costs and improve insurance coverage, especially in economically disadvantaged regions are needed.

摘要

背景

毛细支气管炎和肺炎均为严重的下呼吸道感染,对儿童健康有重大影响。本研究旨在探讨中国毛细支气管炎和肺炎患儿的经济负担及相关影响因素。

方法

采用面对面访谈方式,对 2019 年 1 月至 10 月在上海、郑州和昆明 3 个不同经济发展水平地区的住院毛细支气管炎和肺炎患儿及其监护人进行调查。收集患儿的人口学资料和费用。采用多元线性回归分析探讨疾病经济负担的影响因素。

结果

共纳入毛细支气管炎患儿 338 例,肺炎患儿 529 例。毛细支气管炎患儿的平均住院日和总费用分别为 4162 元和 5748 元,肺炎患儿分别为 6096 元和 7783 元。上海地区毛细支气管炎和肺炎患儿的费用支出均最低,总费用分别为 3531 元和 3488 元。多元回归分析显示,毛细支气管炎患儿中,地区、医保类型、与患儿关系、误工时间和住院天数与住院费用和总费用均相关(<0.05);肺炎患儿中,地区、医保类型和住院天数与住院费用和总费用均相关(<0.05)。

结论

儿童毛细支气管炎和肺炎给患儿家庭带来沉重的经济负担。不同地区的经济负担存在显著差异,欠发达地区和罹患肺炎的家庭面临更大的经济压力。需要制定有针对性的政策来降低医疗费用和提高医保覆盖范围,特别是在经济欠发达地区。

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本文引用的文献

1
Bronchiolitis.毛细支气管炎。
Lancet. 2022 Jul 30;400(10349):392-406. doi: 10.1016/S0140-6736(22)01016-9. Epub 2022 Jul 1.
2
Hospitalization costs for children with pneumonia in Shanghai, China from 2019 to 2020.2019 年至 2020 年中国上海肺炎患儿的住院费用。
Hum Vaccin Immunother. 2022 Nov 30;18(5):2081459. doi: 10.1080/21645515.2022.2081459. Epub 2022 Jun 2.
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Complicated pneumonia in children.儿童复杂性肺炎。
Lancet. 2020 Sep 12;396(10253):786-798. doi: 10.1016/S0140-6736(20)31550-6.
7
Critical Care Thresholds in Children with Bronchiolitis.毛细支气管炎患儿的重症监护阈值
Am J Perinatol. 2020 Sep;37(S 02):S42-S45. doi: 10.1055/s-0040-1714373. Epub 2020 Sep 8.

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