Economic burden of inpatients with hepatitis B virus infection-related diseases and its impact on family financial status in Qidong, Jiangsu Province, China
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摘要:
目的分析江苏省启东市HBV感染相关疾病住院患者(包括原发性肝癌、乙型肝炎肝硬化和慢性乙型肝炎)的经济负担以及患病对家庭经济的影响。方法采用时间段连续病例整群随机抽样方法,抽取江苏省启东市(县级市)人民医院及启东市传染病医院2014年5月1日-2015年3月31日收治的HBV感染相关疾病住院患者,通过问卷调查收集其人口社会学信息、临床信息、近3年的直接医疗费用、直接非医疗费用、因患病所致的误工损失及患病对家庭经济的影响。采用Wilcoxon秩和检验或KruskalWallis H秩和检验分析疾病临床分期、年龄、性别、受教育程度、职业、医保类型、家庭收入等因素对经济负担的影响。通过χ2检验或Fisher精确检验分析HBV感染后不同疾病类型住院患者家庭经济压力的差异。结果 HBV相关原发性肝癌、乙型肝炎肝硬化、慢性乙型肝炎住院患者近3年的经济负担总和分别为94 001元、63 421元和39 360元;其中直接医疗费用分别占84.7%、83.6%和89.9%;近1年的自付费用分别占家庭年收入的99.6%、59.4%和16.7%。3组患者自述经济压力很大比例之间比较,差异...
Abstract:Objective To investigate the economic burden of inpatients with hepatitis B virus (HBV) infection-related diseases (including primary liver cancer, hepatitis B cirrhosis, and chronic hepatitis B) and its impact on family financial status in Qidong, Jiangsu Province, China.Methods Cluster random sampling was used to select consecutive cases of HBV infection-related diseases who were hospitalized in The People's Hospital of Qidong and Qidong Hospital for Infectious Diseases from May 1, 2014 to March 31, 2015.A questionnaire survey was performed to collect their demographic data, clinical data, direct medical costs within the past three years, direct non-medical costs, loss of income due to missed work, and the impact of disease on family financial status.The Wilcoxon rank sum test or the Kruskal-Wallis H rank sum test was used to analyze the impact of various factors on economic burden, such as clinical stage, age, sex, educational level, occupation, type of medical insurance, and family income.The chi-square test or Fisher's exact test was used to analyze the difference in family economic pressure caused by different disease types after HBV infection.Results The total costs of primary liver cancer, hepatitis B cirrhosis, and chronic hepatitis B within the past three years were 94001 yuan, 63421 yuan, and 39360 yuan, respectively, and direct medical costs accounted for 84.7%, 83.6%, and 89.9%, respectively.The self-paid costs within the past one year accounted for99.6%, 59.4%, and 16.7%, respectively, of the annual family income.There was a significant difference in the proportion of patients with great economic pressure between the three groups (38.7% vs 43.1% vs 11.3%, χ2=30.066, P<0.001) .There were also significant differences in the number of missed working days and loss of income due to missed work (7903 yuan vs 6280 yuan vs 2600 yuan, χ2=68.601, P<0.001) .Conclusion HBV infection-related diseases bring considerable burden to inpatients and their families, and the economic burden increases with a longer course of disease and more serious conditions.With the progression of chronic hepatitis B to hepatitis B cirrhosis and primary liver cancer, diseases impose greater economic pressure on families, and patients themselves and their relatives may suffer from greater loss of income due to missed work.Prevention and control of HBV infection has great social and economic benefits.
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Key words:
- liver neoplasms /
- liver cirrhosis /
- hepatitis B, chronic /
- hepatitis B virus /
- cost of illness
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