河南省农村家庭经济条件与肺结核病之间的关系研究  

Study on the Relationship Between Pulmonary Tuberculosis and Household Economic Status in the Rural Area of Henan Province, China

作　　者：王国杰[1] 刘靖恒 Adrian Sleigh Sukhan Jackson 杜长梅[5] 刘禧礼[1] 

机构地区：[1]河南省疾病预防控制中心,郑州450003 [2]郑州市第二按摩医院,郑州450000 [3]澳大利亚国立大学流行病学与人群健康国家中心 [4]澳大利亚昆士兰大学经济学院 [5]河南省胸科医院,郑州450000

出　　处：《中国卫生经济》2006年第3期52-56,共5页Chinese Health Economics

基　　金：UNDP/WB/WHOTDR资助项目(A10166);河南省科技发展计划国际科技合作项目(034664004)。

摘　　要：目的:探讨农村家庭经济条件与肺结核发病的关系及在DOTS化疗管理、免费诊断和治疗策略下,肺结核对病人家庭经济条件的影响。方法:首先,选取160例新发初治涂阳肺结核病人作为病例,每个病例选取2名与病例住所相邻、同性别和同年龄组的正常人作为对照组,采用发病前的家庭年收入与家庭财产2项指标衡量家庭经济条件,进行1:2配对病例对照研究;然后,对选取的所有病例进行随访收集有关费用;应用OR值及其95%的可信区间来估计其相对危险度;采用平均每例病人的家庭费用及其占家庭年收入的百分比来衡量结核病对家庭经济条件的影响。结果:160例肺结核病人发病前家庭年收入和家庭财产位于上等水平的分别占28.1%和25.6%,位于中等水平的分别占42.5%和35.6%,位于下等水平的分别占29.4%和38.8%,320例对照组同期的家庭年收入和家庭财产位于上等水平的分别占34.7%和37.2%,位于中等水平的分别占42.8%和33.1%,位于下等水平的分别占22.5%和29.7%;以上等水平作参照,单因素条件Logistic回归分析,家庭年收入的中等和下等OR值及其95%的可信区间分别为1.6(1.1￣2.8)和2.3(1.2￣4.4),家庭财产的中等和下等OR值及其95%的可信区间分别为1.7(1.1￣2.8)和2.1(1.3￣3.6),采用多因素条件Logistic回归分析后,家庭财产仍具有统计学意义,且OR值仍随着家庭经济条件水平的降低而增高,趋势性检验P值均小于0.05;肺结核病人家庭的直接费用平均为2772.0元,占平均病人家庭年收入的55.5%。我国结核病控制项目治疗下病人家庭的直接费用平均为2504.0元,占病人家庭年收入的50.1%;其他国家结核病控制项目治疗下病人家庭的直接费用平均为3360.0元,占病人家庭年收入的67.3%。结论:虽然,我国经济取得了快速发展,人民生活水平大幅度提高,但农村家庭经济条件差仍是肺结核病的重要危险因素,在实施DOTS策略及免费诊�Objective： To study the relationship between incidence of pulmonary tuberculosis（PTB） and household economic status（HES）, and the impact of pulmonary tuberculosis on HES under the strategies of DOTS, free diagnosis and therapy in the rural area of Henan province. Methods： 1：2 matched case-control study method was conducted firstly; 160 new smear positive PTB patients notified and registered by four county＇s anti-TB institutions in Henan from october 2002-march 2004, were selected as cases; at same time, two healthy persons were selected to match each ease, who were the same sex and age group as the case, from the nearest neighbors of the case; two indicators, annual household income and household property, were used to estimate the HES. Secondly all cases were followed-up to collect the related cost about one year later. The value of OR and 95% CI was used to estimate the relative risk; average household cost and its percentage by annual income per household were used to estimated the economic burden on patient＇s household. Results： Among the 160 patients, the percentages of high, middle and low level of annual household income were 28.1%, 42.5% and 29.4% respectively and those of household property were 25.6%, 35.6% and 38.8% respectively; among the 320 controls, the percentages of high, middle and low level of annual household income were 34.7%, 42.8% and 22.5% respectively, and those of household property were 37.2%, 33.1% and 29.7% respectively. Regarding the high level as conference, with univariate conditional logistic regression analysis, the values of OR and 95% CI of household income were 1.6（1.1-2.8） of middle level, 2.3（1.2-4.4） of low level and those of household property were 1.7（1.1-2.8） of high level, 2.1（1.3-3.6） of low level; with multivariate conditional logistic regression analysis, household property still was significantly associated with PTB; the average direct cost of PTB patients is 2 772 yuan, accounting for 55.5% of average annual income per household;

关 键 词：结核病 肺 流行病学 家庭经济危险因素 费用 

分 类 号：R521[医药卫生—内科学]