济南地区支气管哮喘经济负担及其影响因素分析

发布时间：2019-04-24 09:58

【摘要】：目的：调查总结济南地区2009年支气管哮喘患者治疗花费、误工误学数据资料,获得该地区支气管哮喘患者的经济负担状况,并分析其相关影响因素,为合理控制支气管哮喘发作、降低支气管哮喘治疗费用提供合理化建议。方法：采用横断面多级分层随机抽样,将济南地区居民分成城区和农村两层,根据济南市公安局提供的行政区划和人口信息再逐级分层,将全部在册户口并且实际在本地居住6个月以上的所有家庭成员作为调查对象。参照ISAAC等国际广泛认可的过敏性疾病调查问卷及2008年哮喘疾病防治指南制定调查问卷。问卷包括初筛问卷和专业问卷两部分。对问卷的问题“您曾经有过“哮喘”吗”或(和)“您曾经被医生诊断为哮喘吗”回答“是”,并且对问题“在过去的任何时间里,是否有反复发作(3次以上)的如下症状中的一个或多个：发作性憋气、喘息或哮喘、咳嗽、胸闷,或出气时胸部有鸣笛样的“哮鸣音”或发出“嘶嘶”的声音”,回答“是”且排除其他心肺疾病则诊断为哮喘。调查采取入户面对面填写问卷的方式获得资料。建立Access数据库,两次录入数据。依据济南2009年支气管哮喘调查资料,结合当年支气管哮喘患病率,利用直接法和人力资本法,测算济南城市居民和乡镇农业人口支气管哮喘患者的经济负担。使用SPSS13.0软件进行统计分析,并运用单因素卡方检验、多因素Logistic回归等统计方法,分析影响支气管哮喘治疗费用的因素。结果：总共接受调查的人数为13645人,有效问卷数为13419份,问卷合格率为98.3%,其中城市6995人,农村6424人,男6571人,女6848人。哮喘患者152例,患病率为1.1%。152名患者的年总直接医疗费用为471504元,人均3102元；总直接非医疗费用为109440元,人均720元,年人均直接经济负担为3822元。城市和农村哮喘患者及其家人年均误工日分别为10天／年和15天／年,总间接经济负担为84573元,人均556元。年总经济负担为665517元,人均4378元。以同年济南地区城市和农村居民支气管哮喘总体患病率1.1%为基础,测算该地区支气管哮喘患者疾病总经济负担为2.90亿元,其中直接经济负担是2.53亿元,间接经济负担是0.37亿元。城镇哮喘患者年总经济负担为2.74亿元,农村哮喘患者年总经济负担为0.16亿元。合并过敏性鼻炎、患有其他心肺疾病、因哮喘住院、未按照GINA规范化治疗及吸烟指数是影响济南地区支气管哮喘经济负担的主要因素。结论：济南地区支气管哮喘患者经济负担沉重,吸烟、没有按照GINA规范化治疗、住院、合并鼻炎及其他心肺疾病是导致经济负担增加的主要原因。
[Abstract]:Objective: to investigate and summarize the data of treatment cost and misstudy of bronchial asthma patients in Jinan area in 2009, and to obtain the economic burden of bronchial asthma patients in this area, and to analyze the related influencing factors. In order to control the attack of bronchial asthma reasonably, reduce the cost of treatment of bronchial asthma to provide reasonable suggestions. Methods: according to the administrative division and population information provided by Jinan Public Security Bureau, the residents in Jinan area were divided into two layers: urban area and rural area by cross-sectional multi-level stratified random sampling, and then stratified according to the administrative division and population information provided by Jinan Municipal Public Security Bureau. All family members who have registered accounts and have actually resided locally for more than 6 months are surveyed. Reference to ISAAC and other internationally recognized questionnaire for allergic diseases and asthma disease prevention and treatment guidelines in 2008 to develop questionnaires. The questionnaire includes two parts: primary screening questionnaire and professional questionnaire. To the questionnaire question "have you ever had asthma" or (and) "have you ever been diagnosed with asthma by a doctor" answer "Yes" and at any time in the past, Whether there is one or more of the following symptoms of recurrent attacks (more than three times): paroxysmal choking, wheezing or asthma, coughing, chest tightness, or "whistling" or "hissing" in the chest when out of breath. Answering yes and excluding other cardio-pulmonary diseases is diagnosed as asthma. The survey was conducted by filling out the questionnaire face-to-face. Establish Access database and input data twice. According to the survey data of bronchial asthma in Jinan in 2009, combined with the prevalence rate of bronchial asthma in that year, the economic burden of bronchial asthma patients in Jinan city residents and rural agricultural population was calculated by using direct method and human capital method. The statistical analysis was carried out with SPSS13.0 software, and the factors affecting the treatment cost of bronchial asthma were analyzed by using univariate chi-square test and multi-factor Logistic regression. Results: the total number of people surveyed was 13645, the number of valid questionnaires was 13419, and the qualified rate was 98.3%. Among them, 6995 were in cities, 6424 in rural areas, 6571 in men and 6848 in women. The total annual direct medical expenses were 471504 yuan (3102 yuan), the total direct non-medical expenses were 109440 yuan (109440 yuan), the annual direct economic burden (3822 yuan) was 3822 yuan (per capita) in 152 patients with asthma, the prevalence rate was 1.1%, and the annual direct medical expenses were 471504 yuan, 3102 yuan per person, 109440 yuan and 3822 yuan respectively. The average annual delayed working days of asthma patients and their families in urban and rural areas were 10 days / year and 15 days / year, respectively. The total indirect economic burden was 84573 yuan, with a per capita of 556 yuan. The annual total economic burden is 665517 yuan, per capita 4378 yuan. On the basis of 1.1% of the total prevalence of bronchial asthma among urban and rural residents in Jinan in the same year, the total economic burden of bronchial asthma in this area is estimated to be 290 million yuan, of which the direct economic burden is 253 million yuan. The indirect economic burden is 37 million yuan. The annual total economic burden of asthma patients in urban and rural areas was 274 million yuan and 16 million yuan respectively. The main factors affecting the economic burden of bronchial asthma in Jinan area were allergic rhinitis, other cardio-pulmonary diseases, hospitalization of asthma, non-standardized treatment according to GINA and smoking index. Conclusion: the economic burden of bronchial asthma patients in Jinan area is heavy, smoking, no standardized treatment according to GINA, hospitalization, rhinitis and other cardio-pulmonary diseases are the main reasons leading to the increase of economic burden.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R562.25

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