江苏省启东市HBV感染相关疾病的医疗费用及其影响因素分析

王宇婷; 黄慧瑶; 秦海松; 姚红玉; 陈松; 郁冬梅; 代敏; 陈陶阳; 曲春枫; 石菊芳

doi:10.3969/j.issn.1001-5256.2017.01.013

江苏省启东市HBV感染相关疾病的医疗费用及其影响因素分析

DOI: 10.3969/j.issn.1001-5256.2017.01.013

1. 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院免疫学研究室
2. 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院城市癌症早诊早治项目办公室
3. 启东市传染病医院
4. 启东市人民医院,启东肝癌防治研究所科研科
5. 启东市人民医院,启东肝癌防治研究所病因室
6. 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院分子肿瘤学国家重点实验室

基金项目:

“十二五”传染病国家科技重大专项(2012ZX10002008-001,003)；江苏省科技支撑计划(BE2013657)；

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中图分类号: R512.62
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出版历程
- 收稿日期: 2016-08-23
- 出版日期: 2017-01-20

Medical expenditure of hepatitis B virus infection and its impact factors analysis in Qidong,Jiangsu Province

Department of Immunology,National Cancer Center,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College

Research funding:

摘要

摘要:
目的量化江苏省启东市HBV感染相关疾病的例均医疗费用,并分析其构成及影响因素。方法基于启东市人民医院与启东市传染病医院,采用时间阶段连续病例整群抽样法,选取2012年HBV感染相关原发性肝癌（n=217）、乙型肝炎肝硬化（n=234）、慢性乙型肝炎（CHB,n=136）住院患者,收集2010年1月-2012年12月住院及门诊费用合计（例均医疗费用）及相关基本和临床信息。采用专家咨询法,调查急性乙型肝炎、HBs Ag无症状携带者和HBV隐匿感染者的例均医疗费用。不同年份的费用采用2014年医疗保健消费价格指数进行转换。计量资料组间比较采用独立样本t检验,多组间比较采用方差分析,组内进一步两两比较采用SNK-q检验;采用多重线性回归分析（逐步回归法）进行例均医疗费用的影响因素探讨。结果 HBV感染相关原发性肝癌、乙型肝炎肝硬化、CHB患者2010-2012年的例均医疗费用分别为30 183元、22 066元和15 703元,住院费用分别为29 058元、21 383元和15 394元,占例均医疗费用的比例分别为96.3%、96.9%、98.0%;药品费用分别占例均住院费用的55.0%、73...
- 肝炎病毒,乙型 /
- 医疗费用 /
- 经济负担
Abstract:
Objective To quantify the medical expenditure per case of patients with hepatitis B virus- related diseases in Qidong,Jiangsu,China,and analyze its composition and related influencing factors. Methods Cluster sampling was used to select consecutive cases in The People's Hospital of Qidong and Qidong Infectious Diseases Hospital. A total of 217 hospitalized patients of HBV related primary liver cancer,234 hospitalized patients with HBV related B cirrhosis,and 136 hospitalized patients with chronic hepatitis B( CHB) were enrolled,and the total inpatient and outpatient costs( medical costs per case) from January 2010 to December 2012 and related clinical data were collected from the hospital records. Expert consultation was performed to investigate the costs per case of patients with acute hepatitis B,HBs Ag asymptomatic carriers,and occult HBV infection. Costs in different years were converted based on the consumer price index for medical and health consumption in 2014. The independent samples t- test was used for comparison of continuous data between groups,an analysis of variance was used for comparison between multiple groups,and the SNK- q test was used for comparison within each group. Multiple linear regression analysis( stepwise regression) was used to investigate the influencing factors for medical costs per case. Results The medical costs per case of patients with HBV related primary liver cancer,patients with HBV related cirrhosis,and CHB patients from 2010 to 2012 were30183 RMB,22066 RMB,and 15703 RMB,respectively,and the inpatient costs were 29058 RMB,21383 RMB,and 15394 RMB,respectively,which accounted for 96. 3%,96. 9%,and 98. 0% of the medical costs per case. Drug costs of these three groups accounted for55. 0%,73. 4%,and 78. 2% of the medical costs per case,respectively. The number of times of hospitalization( F = 89. 1,67. 7,and11. 5,all P < 0. 001),treatment regimen( F = 21. 8,t =- 2. 1,and t =- 3. 7,P < 0. 001,P = 0. 039,and P < 0. 001),and type of medical insurance( t = 3. 1,2. 6,and 2. 7,P = 0. 002,0. 011,and 0. 012) were influencing factors for medical costs per case,while clinical stage was an influencing factor for medical costs per case only in CHB patients( a multivariate analysis for patients mild,moderate,and severe CHB: β = 1. 238,F = 5. 9,P = 0. 021). The medical costs per case for patients with acute hepatitis B were 5950 RMB,and the annual medical costs for HBs Ag asymptomatic carriers and patients with occult HBV infection ranged from 770 RMB to 1540 RMB. Conclusion The medical costs of HBV related is increasing as the illness progresses. Our results will provide baseline information for the following economic evaluation of vaccination or screening interrention.
- hepatitis B virus /
- medical expenditure /
- economic burden

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参考文献(12)

[1]LI Y,WANG H,ZHANG W,et al.Investigation on the cost of patients with different outcomes related to hepatitis B virus infection in Beijing[J].Basic Clin Med,2014,34(9):1235-1240.(in Chinese)李雁,王怀,张卫,等.北京市HBV感染不同结局患者费用调查[J].基础医学与临床,2014,34(9):1235-1240.

[2]LIANG S,ZHANG SX,MA QS,et al.Study on the direct economic burden of hepatitis B and its economic impact on family in Shenzhen city[J].Chin Heal Econ,2011,30(336):56-58.(in Chinese)梁森,张顺祥,马起山,等.深圳市乙肝住院病人年直接经济负担及对家庭经济影响分析[J].中国卫生经济,2011,30(336):56-58.

[3]YANG SJ,DONG HJ.A study on direct economic burden of chronic hepatitis B-relevant diseases[J].Zhejiang J Prevent Med,2015,27(1):1-9.(in Chinese)杨思嘉,董红军.慢性乙型病毒性肝炎及其相关疾病直接经济负担研究[J].浙江预防医学,2015,27(1):1-9.

[4]LYU JJ,LI RP,XU AQ,et al.Economic burden and related factors on inpatients with HBV-related diseases in Shandong province[J].Chin J Epidemiol,2013,34(3):267-272.(in Chinese)吕静静,李仁鹏,徐爱强,等.山东省乙型肝炎病毒感染相关疾病住院患者经济负担及影响因素分析[J].中华流行病学杂志,2013,34(3):267-272.

[5]LI RP,ZHANG L,XU AQ,et al.Study on the economic burden of hepatitis B virus related-diseases in Shandong[J].Chin Heal Econ,2013,32(370):8-10.(in Chinese)李仁鹏,张丽,徐爱强,等.山东省乙型肝炎病毒感染相关疾病经济负担分析[J].中国卫生经济,2013,32(370):8-10.

[6]GUO FT,WANG XJ,LIU JC,et al.Research on the direct costs and its influencing factors of the patients suffering from type B viral hepatitis and its related diseases in 4 towns of Shanxi province[J].China Mod Doct,2014,52(10):10-14.(in Chinese)郭峰涛,王小娟,刘近春,等.山西省4地市乙肝及相关疾病直接费用及其影响因素分析[J].中国现代医生,2014,52(10):10-14.

[7] SHI JF,SHI CL,YUE XP,et al.Economic burden of cancer in China during 1996-2014:a systematic review[J].Chin J Oncol,2016,38(12):929-941.(in Chinese)石菊芳,石春雷,岳馨培,等.我国1996-2014年癌症经济负担研究进展[J].中华肿瘤杂志,2016,38(12):929-941.

[8]YU BR,LI NN,YAN BY,et al.Compared analysis of the length of stay and expenses of inpatients with chronic hepatitis B in county and municipal hospitals under different health insurances[J].Med Society,2012,25(12):33-35.(in Chinese)于保荣,李宁宁,颜丙玉,等.不同医疗保障制度下县市两级医院慢性乙肝患者住院床日数及住院费用比较分析[J].医学与社会,2012,25(12):33-35.

[9]LIU GY,ZHANG KJ,ZHANG H,et al.Canonical correlation analysis on hospital costs and medical insurance payment of hepatitis B patients[J].Chin Gen Pract,2016,19(7):828-830.(in Chinese)刘桂圆,张开金,张华,等.乙型肝炎患者住院费用与医疗保险支付的典型相关分析[J].中国全科医学,2016,19(7):828-830.

[10]Chinese Journal of Hepatology,Journal of Clinical Hepatology and Chinese Hepatology.To improve the accessibility of hepatitis B treatment[J].J Clin Hepatol,2016,32(6):1031-1032.(in Chinese)中华肝脏病杂志,临床肝胆病杂志,《肝脏》杂志.再论提高我国乙型肝炎治疗的可及性[J].临床肝胆病杂志,2016,32(6):1031-1032.

[11]XU MM,CHEN Y.Current research on adherence to antiviral therapy in patients with chronic hepatitis B[J].J Clin Hepatol,2015,31(10):1735-1739.(in Chinese)徐曼曼,陈煜.慢性乙型肝炎患者抗病毒治疗依从性的研究现状[J].临床肝胆病杂志,2015,31(10):1735-1739.

[12]ZHENG H,WANG FZ,ZHANG GM,et al.Study on health-seeking behavior and influencing factors among Chinese hepatitis B surface antigen positive adults[J].Chin J Epidemiol,2016,37(4):455-459.(in Chinese)郑徽,王富珍,张国民,等.中国社区成年人群HBs Ag阳性者医疗和就诊行为及相关影响因素研究[J].中华流行病学杂志,2016,37(4):455-459.

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