摘要
目的了解中国东部三市耐多药结核病(multi-drug resistant tuberculosis,MDR-TB)患者的经济负担情况,寻找减轻患者经济负担的方法。方法采用自行设计的调查问卷对正在治疗的江苏省徐州市、宿迁市和江西省赣州市定点医院登记治疗的MDR-TB患者进行面对面调查,对已经结束治疗的患者进行电话调查,收集患者基本情况、经济负担等信息。采用χ^(2)检验、线性回归等方法分析MDR-TB患者的经济负担情况。结果三市共登记治疗MDR-TB患者233例,其中接受全球基金项目医疗费减免患者82人,最终151例患者纳入分析,平均年龄(43.36±16.18)岁,男性患者124例(82.1%)。MDR-TB患者直接经济负担平均为28987元,中位数为23740(14100~37580)元。多因素线性回归结果显示徐州患者直接经济负担显著高于宿迁(P=0.001)和赣州(P<0.001)。治疗前MDR-TB患者家庭年收入中位数为40000(20000~60000)元,患者个人收入中位数为15000(0~36000)元。所有患者中产生灾难性卫生支出的家庭比例为48.3%,徐州市患者产生灾难性卫生支出的家庭比例显著高于另两市(P=0.003)。结论中国东部三市MDR-TB患者经济负担较重,因医保报销政策和用药方案的不同而差异较大。政府应该加强医疗保险的报销范围或报销力度,增加MDR-TB患者的费用补贴,减轻患者的经济负担。
Objective To understand the economic burden of multi-drug resistant tuberculosis(MDR-TB)patients in three cities in eastern China,and to find ways to reduce the financial burden on the patients.Methods The subjects of the study were MDR-TB patients registered and treated in designated hospitals in Xuzhou,Suqian of Jiangsu Province and Ganzhou of Jiangxi Province.Face-to-face investigation was conducted on the patients undergoing treatment,and telephone survey was conducted on the patients who have completed treatment by a self-designed questionnaire to collect demographic sociological information and economic burden of MDR-TB patients.χ^(2) test and linear regression were used to analyze the economic burden of MDR-TB patients.Results A total of 233 patients with MDR-TB were registered in the 3 cities,of which 82 patients received reduction of medical expenses from global fund projects.Therefore,151 patients with an average age of(43.36±16.18)years were successfully investigated finally.There were 124 male patients(82.1%).The total direct financial burden of MDR-TB patients was 28987 yuan on average,with a median of 23740(14100-37580)yuan.The results of multivariate linear regression showed that the direct economic burden of the patients in Xuzhou was significantly higher than that in Suqian(P=0.001)and Ganzhou(P<0.001).The annual median family income of MDR-TB patients before treatment was 40000(20000-60000)yuan,and the median family income before treatment was 20000(0-36000)yuan.The percentage of families with catastrophic health expenditure was 48.3%.The proportion of patients with catastrophic health expenditure in Xuzhou was significantly higher than that in the other two cities(P=0.003).Conclusion The economic burden of MDR-TB patients in the 3 cities in eastern China was heavy and varied greatly with different medical insurance policies and therapeutic regimens.The government should strengthen the coverage or reimbursement of medical insurance,and increase the subsidy of MDR-TB patients to reduce the econ
作者
李志鹏
盛宇超
张杨
周慧
张海清
孟旭
赵琦
LI Zhi-peng;SHENG Yu-chao;ZHANG Yang;ZHOU Hui;ZHANG Hai-qing;MENG Xu;ZHAO Qi(Department of Epidemidogy,School of Public Health,Fudan University,Shanghai 200032,China;Department of Chronic Infectious Diseases,Center for Disease Control and Prevention of Suqian City,Suqian 223699,Jiangsu Province,China;Department of Tuberculosis Control,Center for Disease Control and Prevention of Xuzhou City,Xuzhou 210009,Jiangsu Province,China;Department of Tuberculosis Control,Center for Disease Control and Prevention of Ganzhou City,Ganzhou 341000,Jiangxi Province,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2021年第4期481-487,共7页
Fudan University Journal of Medical Sciences
基金
上海市第四轮公共卫生三年行动计划(15GWZK0101)。
关键词
结核病
耐药
经济负担
灾难性卫生支出
tuberculosis
drug-resistant
economic burden
catastrophic health expenditure
