四地市结核病定点医院住院初治涂阳肺结核患者医疗费用及经济负担分析  

The analysis of medical expense and economic burden in new smear positive pulmonary tuberculosis cases from 4 prefecture level designated TB hospitals

作　　者：王娜[1,2] 王黎霞[3] 李仁忠[4] 

机构地区：[1]山东省东营市疾病预防控制中心结核病防治科,257091 [2]中国疾病预防控制中心 [3]中国疾病预防控制中心结核病预防控制中心主任办公室 [4]中国疾病预防控制中心结核病预防控制中心耐药监测部

出　　处：《中国防痨杂志》2012年第2期79-84,共6页Chinese Journal of Antituberculosis

基　　金："十一五"国家重大科技专项(2008ZX10003-007)

摘　　要：目的了解初治涂阳肺结核患者在定点医院住院治疗的医疗费用及其对家庭造成的经济负担。方法选择浙江省衢州市、黑龙江省大庆市、河南省濮阳市、重庆市万州区4个地区的4所定点医院,对2009年8月之前曾经在这4所医院接受治疗的106例初治涂阳肺结核患者进行问卷调查并查阅病案,收集患者社会经济情况、医疗费用等数据,其中对患者的社会经济基本情况以及各项费用进行描述性分析。结果4所定点医院初治涂阳肺结核患者的医疗费用中位数为11 282元,90.8%(69/76)的患者产生了灾难性卫生支出。享受医保补偿的患者报销后疾病经济负担有所下降,但仍有68.4%(52/76)的患者产生了灾难性卫生支出。因治疗肺结核而借债的人数比例为47.2%(50/106),有76.0%(38/50)的患者至调查之日还完全没有偿还借款,并且有58.5%(62/106)的初治涂阳肺结核患者自感经济负担较重。结论初治涂阳肺结核患者在结核病定点医院住院治疗医疗费用较高,给患者家庭造成了灾难性卫生支出。Objective To analyze the medical expense and the family economic burden of new smear positive pulmonary tuberculosis cases in TB designated hospitals.Methods Four TB designated hospitals in 4 cities were selected,and 106 new smear positive patients in these hospital before August 2009 were investigated by questionnaire and medical record review.Information about the social economic conditions and medical expenses was collected.Descriptive analysis was done for patients’ social economic conditions and medical expenses.Results The median of the medical expense of the new smear positive patients in 4 designated hospitals is 11 282 RMB.90.8%（69/76）patients have a catastrophic expenditure.The economic burden decreased after the reimbursement of the people with health insurance,but 68.4%（52/76）patients still have a catastrophic health expenditure.The percentage of people who were in debt caused by TB is 47.2%（50/106）.Among them,76.0%（38/50） have not yet pay off their debt by the investigation day.58.5%（62/106） new smear positive pulmonary tuberculosis patients feel a heavy economic burden.Conclusion The medical expense of new smear positive patients in designated hospital is high,leading to the catastrophic health expenditures for their family.

关 键 词：结核 肺/经济学 住院病人 费用 医疗 

分 类 号：R521[医药卫生—内科学]