老年痴呆住院患者疾病经济负担及影响因素研究
发布时间：2018-11-19 08:37
【摘要】：目的通过对青岛市在机构(养老院、护理院、精神卫生中心)中接受护理的老年痴呆患者进行调查,测算其直接经济负担和间接经济负担,并分析老年痴呆患者疾病经济负担的影响因素,为合理配置和利用医疗卫生资源提供依据,为减轻患者疾病经济负担提供可行性建议。方法采用自行设计的调查问卷,借助医疗机构中的HIS系统,收集患者的基本信息、疾病费用等,运用数据处理软件EPIDATA3.0和统计分析软件SPSS18.0,同时结合相关的卫生经济学理论和卫生统计学方法,对收集到的数据进行描述性分析、非参数检验和二项logistic回归分析;采用现场访谈法,对家属及机构中的工作人员进行访谈,了解老年痴呆患者的其他相关信息,以补充调查问卷中的缺失信息,根据调查结果测算老年痴呆患者的疾病经济负担并分析影响疾病经济负担的主要因素。结果三个机构(养老院、护理院、精神卫生中心)中312例老年痴呆患者的月均直接经济负担为834738.93元,月均间接经济负担为308686.40元;平均每位患者的直接经济负担为2675.45元,间接经济负担为989.38元。影响因素方面,老年痴呆患者的单因素分析结果显示,机构类型、年龄、婚姻状况、受教育程度、职业类型、家庭人均月收入、收入水平、日均社交活动时间、日均锻炼时间、自理程度、有无并发症及有无医疗保险等影响老年痴呆患者的直接经济负担,而婚姻状况、家庭经济状况、日均锻炼时间、自理程度、护理服务等级以及家属月均误工时间等影响老年痴呆患者的间接经济负担;多因素分析结果显示,机构类型、家庭人均月收入、有无并发症、婚姻状况以及自理程度等对直接经济负担的影响更为显著,而家庭人均月收入、自理程度、所接受的护理服务等级对间接经济负担影响更为显著。结论与建议不同机构老年痴呆患者疾病经济负担存在差异,除了患者基本情况外,有无医疗保险,自理程度,护理服务等级等均是影响患者疾病经济负担的因素,因此建议关爱、照护老年人群,降低老年痴呆发病率;坚持公益性为导向,对不同机构进行分类管理;建立并完善老年痴呆患者护理保险制度,减轻疾病经济负担;加强对老年痴呆患者的治疗和护理,延缓病情恶化。
[Abstract]:Objective to investigate the direct and indirect economic burden of Alzheimer's disease patients in institutions (nursing home, mental health center) in Qingdao. The factors influencing the economic burden of disease in senile dementia patients were analyzed to provide basis for rational allocation and utilization of medical and health resources and feasible suggestions for alleviating the economic burden of disease in patients with Alzheimer's disease. Methods A self-designed questionnaire was used to collect patients' basic information, disease cost, data processing software (EPIDATA3.0) and statistical analysis software (SPSS18.0,) with the help of HIS system in medical institutions. At the same time, combined with relevant health economics theory and health statistics method, the collected data were analyzed by descriptive analysis, non-parametric test and binomial logistic regression analysis. In order to supplement the missing information in the questionnaire, we conducted interviews with family members and staff in institutions to find out other relevant information about Alzheimer's disease patients. According to the survey results, the disease economic burden of senile dementia patients was estimated and the main factors affecting the disease economic burden were analyzed. Results the direct economic burden and indirect economic burden were 834738.93 yuan per month and 308686.40 yuan respectively in three institutions (nursing home, mental health center). The average direct economic burden and indirect economic burden per patient were 2675.45 yuan and 989.38 yuan respectively. In terms of influencing factors, the results of univariate analysis of Alzheimer's disease patients showed that: type of institution, age, marital status, education level, occupation type, monthly income per family, income level, average daily social activity time, daily exercise time, The degree of self-care, complications and medical insurance influence the direct financial burden of senile dementia patients, but marital status, family economic status, daily exercise time, self-care degree, The level of nursing care and the delay time of family members affected the indirect economic burden of senile dementia patients. The results of multivariate analysis showed that the type of institution, the per capita monthly income of the family, the complications, the marital status and the degree of self-care had more significant effects on the direct financial burden, while the per capita monthly income of the family, the degree of self-care, etc. The level of nursing services received had a more significant impact on the indirect economic burden. Conclusion there are differences in the economic burden of senile dementia patients in different institutions. Besides the basic condition of the patients, medical insurance, self-care degree and nursing service grade are all the factors that affect the disease financial burden of the patients. Therefore, it is suggested to care and care for the elderly and reduce the incidence of dementia. Adhere to the guidance of public welfare, to different institutions for classified management; establish and improve the nursing insurance system for dementia patients, reduce the economic burden of disease; strengthen the treatment and nursing of senile dementia patients, delay the deterioration of the disease.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.74
本文编号：2341731
[Abstract]:Objective to investigate the direct and indirect economic burden of Alzheimer's disease patients in institutions (nursing home, mental health center) in Qingdao. The factors influencing the economic burden of disease in senile dementia patients were analyzed to provide basis for rational allocation and utilization of medical and health resources and feasible suggestions for alleviating the economic burden of disease in patients with Alzheimer's disease. Methods A self-designed questionnaire was used to collect patients' basic information, disease cost, data processing software (EPIDATA3.0) and statistical analysis software (SPSS18.0,) with the help of HIS system in medical institutions. At the same time, combined with relevant health economics theory and health statistics method, the collected data were analyzed by descriptive analysis, non-parametric test and binomial logistic regression analysis. In order to supplement the missing information in the questionnaire, we conducted interviews with family members and staff in institutions to find out other relevant information about Alzheimer's disease patients. According to the survey results, the disease economic burden of senile dementia patients was estimated and the main factors affecting the disease economic burden were analyzed. Results the direct economic burden and indirect economic burden were 834738.93 yuan per month and 308686.40 yuan respectively in three institutions (nursing home, mental health center). The average direct economic burden and indirect economic burden per patient were 2675.45 yuan and 989.38 yuan respectively. In terms of influencing factors, the results of univariate analysis of Alzheimer's disease patients showed that: type of institution, age, marital status, education level, occupation type, monthly income per family, income level, average daily social activity time, daily exercise time, The degree of self-care, complications and medical insurance influence the direct financial burden of senile dementia patients, but marital status, family economic status, daily exercise time, self-care degree, The level of nursing care and the delay time of family members affected the indirect economic burden of senile dementia patients. The results of multivariate analysis showed that the type of institution, the per capita monthly income of the family, the complications, the marital status and the degree of self-care had more significant effects on the direct financial burden, while the per capita monthly income of the family, the degree of self-care, etc. The level of nursing services received had a more significant impact on the indirect economic burden. Conclusion there are differences in the economic burden of senile dementia patients in different institutions. Besides the basic condition of the patients, medical insurance, self-care degree and nursing service grade are all the factors that affect the disease financial burden of the patients. Therefore, it is suggested to care and care for the elderly and reduce the incidence of dementia. Adhere to the guidance of public welfare, to different institutions for classified management; establish and improve the nursing insurance system for dementia patients, reduce the economic burden of disease; strengthen the treatment and nursing of senile dementia patients, delay the deterioration of the disease.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.74
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