上海市部分区(县)细菌性痢疾的疾病经济负担及影响因素
Study of Disease Economic Burden and Its Determinants Associated with Bacillary Shigellosis in Partial Districts of Shanghai
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摘要:
目的 测算上海市部分区(县)细菌性痢疾(简称菌痢)的疾病经济负担,探讨该负担的影响因素,为科学制订菌痢的防治策略提供经济学依据。 方法 于2009 年4 月至2010 年4 月,采用问卷调查上海市部分区(县)534名菌痢患者的直接医疗费用和直接非医疗费用,使用人力资本法测算间接经济负担,运用多元线性回归模型分别探讨菌痢直接经济负担与间接经济负担的影响因素。 结果 上海市部分区(县)门诊菌痢患者和住院菌痢患者的人均直接经济负担分别为530.79 元(人民币,下同)和3 004.57 元;人均间接经济负担分别为243.13 元和328.02 元;人均总经济负担分别为773.92 元和3 332.59 元。多元线性回归模型显示,年龄、医疗保险状况、症状等级、发病距诊断天数、就诊医院级别和居住地区是直接经济负担的影响因素;居住地区和年龄是间接经济负担的影响因素。 结论 上海市菌痢的疾病经济负担不容忽视,特别是住院菌痢患者的疾病经济负担较高,仍需进一步加强对菌痢的防治工作。 Abstract:Objective To evaluate the disease economic burden associated with bacillary Shigellosis and probe its determinants in partial districts of Shanghai and provide the economical basis for formulating the scientific prevention strategy against bacillary Shigellosis. Methods Questionnaires were used to investigate the direct medical costs and direct non-medical costs, and human capital method was adopted to evaluate the indirect economic burden of 534 cases of bacillary Shigellosis in partial districts of Shanghai from Apr 2009 to Apr 2010. The multi-linear regression model was used to explore the determinants of direct economic burden and indirect economic burden of bacillary Shigellosis. Results The average direct burden of outpatient and inpatient bacillary Shigellosis cases were 530.79 and 3 004.57 Yuan(RMB)respectively in partial districts of Shanghai, and the average indirect burden were 243.13 and 328.02 Yuan respectively. The average total economic burden of outpatient and inpatient bacillary Shigellosis cases were 773.92 and 3 332.59 Yuan respectively. Multi-linear regression model showed that age, status of medical insurance, severity of symptoms, days from onset to diagnosis, hospital level and resdential district were determinants of direct economic burden, meanwhile, residential district and age were determinants of indirect economic burden. Conclusion The economic burden associated with bacillary Shigellosis in Shanghai should not be ignored, particularly, the economic burden of inpatient bacillary Shigellosis cases was comparatively high. It is still necessarily to strengthen the prevention and control of bacillary Shigellosis.
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