河南省耐多药和非耐多药结核病患者经济状况及相关费用的比较  

The economic status and treatment cost of MDR-TB patients compared to non-MDR-TB patients in Henan province

作　　者：孙燕妮[1] 王国杰[2] 甄新安[2] 刘占峰[2] Harley David Hall Gillian Vally Hassan Sleigh Adrian 

机构地区：[1]澳大利亚国立大学澳大利亚国家流行病和人口健康中心 [2]河南省疾病预防控制中心结核病防治所预防控制室 [3]墨尔本澳大利亚La Trobe大学公共卫生和人类生物科学院

出　　处：《中国防痨杂志》2012年第12期773-779,共7页Chinese Journal of Antituberculosis

摘　　要：目的调查研究并比较河南省耐多药结核病(multidrug-resistant tuberculosis,MDR-TB)和非耐多药结核病(非MDR-TB)患者社会经济情况及相关治疗花费。方法利用2001年河南省参加世界卫生组织结核病耐药监测调查患者数据库,采用Excel生成随机数字表方法随机抽取入选病例。使用问卷访谈形式于2010年对MDR-TB患者和非MDR-TB患者的社会经济状况及结核病相关治疗花费进行访谈性调查研究;共调查访谈234例患者。按照对异烟肼和利福平的耐药状态分为暴露组(MDR-TB患者组)86例和对照组(非MDR-TB患者组)148例。对收集的数据进行t检验和卡方检验。结果暴露组MDR-TB患者家庭年收入低于5000元的比例(55.3%,47/85)明显高于对照组非MDR-TB患者(38.1%,56/147),两组间差异有统计学意义(χ2=6.9,P=0.031)。与同社区其他居民家庭经济情况进行比较:暴露组患者家庭经济情况位于同社区家庭经济水平下1/3等的比例为47.1%(40/85),明显高于对照组32.9%(48/146),两组间差异有统计学意义(χ2=4.6,P=0.032)。与对照组比较,暴露组家庭≤3间的可住房间数的比例明显偏高,分别为37.8%(31/82)和17.9%(26/145),两组间差异有统计学意义(χ2=11.0,P=0.004)。更高比例的暴露组家庭因结核病治疗借款,占19.0%(15/79),对照组占4.5%(6/134),且不能按时偿还(χ2=13.4,P=0.001)。与非MDR-TB患者相比,更高比例的MDR-TB患者在结核病相关治疗花费上支付10 000元以上分别30.2%(26/86)和9.5%(14/148),两组间差异有统计学意义(χ2=19.7,P=0.001)。结论结核病对MDR-TB患者和非MDR-TB患者的社会经济情况有不同程度影响。相比非MDR-TB患者,MDR-TB患者家庭更加贫穷,同时在治疗花费上支出较大。Objective To investigate the socioeconomic status and treatment cost of MDR-TB patients compared to non-MDR-TB in Henan province in 2010 to provide evidence for comprehensive TB control strategies.Methods Participants were randomly selected by using Excel generated random digits table from an anti-TB drug resistance surveillance survey dataset collected by the Institute for Tuberculosis Control and Prevention,Henan Centre for Disease Control and Prevention in 2001,supported by the World Health Organization.Interviews were carried out using a questionnaire to collect information on the socioeconomic status including wealth and impacts and treatment costs between MDR-TB and non-MDR-TB patients.Bivariate analysis was performed for data analysis.Altogether 234 TB cases were interviewed.Among the interviewed cases,86 were MDR-TB cases and 148 were non-MDR-TB cases based on their anti-TB drug resistance status.In order to compare,t-test was applied in conti-nuous variables and Chi square test was used for categorical variables.Results Compared to non-MDR-TB household,the proportion of annual household income less than 5000 Yuan for MDR-TB patient＇s household was much higher.The difference between the two groups was statistically significant（55.3%,47/85 vs 38.1%,56/147,χ2=6.9,P=0.031）.47.1%（40/85）of MDR-TB patients＇ households were in lower 1/3 in term of economic status compared to other households in the community,while 32.9%（48/146）non-MDR-TB patients＇ household ranked in lower 1/3（χ2=4.6,P=0.032）.Compared to households with non-MDR-TB patients,higher proportion of MDR-TB patients＇ households had bedrooms less than 3（37.8%,31/82 vs 17.9%,26/145）.The difference between the two study groups was statistically significant（χ2=11.0,P=0.004）.More proportion of households with MDR-TB patients reported loan for TB treatment and can not pay back in time（19.0%,15/79 vs 4.5%,6/134 χ2=13.4,P=0.001）.Much higher MDR-TB households paid treatment costs more than 10000 Yuan compared to non-MDR-T

关 键 词：结核 经济学 社会经济因素 费用 医疗 河南省 

分 类 号：R521[医药卫生—内科学]