【作者】 吴来娃； 严非； 王伟； 贾环； 沈鑫； 梅建；

【Author】 WU Laiwai~*,YAN Fei,WANG Wei,JIA Huan,SHEN Xin,MEI Jian. *School of Public Health,Fudan University,Key Laboratory of Public Health Safety of Ministry of Education(Fudan University) Shanghai 200032,China

【机构】 复旦大学公共卫生学院； 复旦大学公共卫生安全教育部重点实验室； 上海市疾病预防控制中心；

【摘要】 目的了解上海市肺结核患者确诊及治疗过程的直接医疗费用及其对家庭造成的经济负担。方法对7个区共491例完成治疗的肺结核病患者进行定量问卷调查。结果肺结核患者的直接医疗总费用均数为8698.5元,中位数为4000.0元。各级政府提供的减免费用占总费用的比例平均稍高于50%,患者自身仍要承担接近一半的直接医疗费用,患者自付费医疗费用占家庭年纯总收入的比例均数和中位数分别为14.9%、5.0%,占家庭年人均纯收入的比例均数和中位数分别为44.1%、12.1%;涂阳患者与涂阴患者可减免的直接医疗总费用比例的差异有统计学意义(P<0.05);有34.4%的患者发生过住院费用,住过院治疗的患者与全程门诊治疗患者的直接医疗总费用之间的差异有统计学意义(P<0.05),住院治疗对患者家庭造成的经济负担相对较重;60.9%的患者使用过辅助药物,辅助药费相对较高。结论上海市肺结核病患者确诊及治疗过程的直接医疗费用相对较高;确诊与治疗过程中住院比例和辅助药物使用比例以及由此产生的医疗费用较高。更多还原

【Abstract】 Objective To understand the direct medical cost for diagnosis and treatment of pulmonary TB patients and its financial burden on family in Shanghai.Methods Quantitative questionnaire investigation of 491 pulmonary TB patients who have completed treatment from 7 districts of Shanghai.Results The mean and median cost of TB patients’ total direct medical cost were 2728.8yuan and 500yuan respectively.The fee supplies provided by government accounted for slightly over 50%among the direct medical cost averagely and the patients still have to pay nearly 50%of the direct medical cost themselves.The ratio of medical cost paid by patients themselves to the net income of the patient’s family was 14.9%(mean),5.0%(median),the ratio of medical cost paid by patients themselves to the net income of the patients was 44.1%(mean),12.1%(median).The relief proportion of the total direct medical cost in smear-positive patients was higher than it in smear-negative patients (P<0.05).There were 34.4%of patients have been hospitalized,and there was significant difference between once-hospitalized patients and entire-processed out-patients in the total direct medical cost(P<0.05).Hospitalized treatment brought relatively heavy financial burden to the TB patients.There were 60.9% of patients with supporting drugs,cost of which was relatively high.Conclusions The diagnosis and treatment costs of TB patients in Shanghai were relatively high.Supporting drugs and hospitalization accounted higher proportion during the process of treatment,and the corresponding costs were relatively high.更多还原