典型城市居民慢性病患病率及患者疾病负担分析  

Prevalence of non-communicable diseases and economic burden of patients in 8 typical cities

作　　者：秦江梅[1] 张艳春[1] 张丽芳[1] 芮东升[2] 毛璐[2] 王丽坤[2] 吴宁[1] 

机构地区：[1]卫生部卫生发展研究中心,北京100191 [2]石河子大学医学院预防医学系

出　　处：《中国公共卫生》2014年第1期5-7,共3页Chinese Journal of Public Health

基　　金：中澳卫生与艾滋病基金项目(HSS408)

摘　　要：目的分析中国8个社区卫生综合改革典型城市居民慢性非传染性疾病(慢性病)患病率和前10位慢性病患者年平均经济负担,确定疾病干预的优先级,为慢性病控制政策的制定提供循证依据。方法收集2011年7—10月杭州、合肥、武汉、成都、无锡、铜陵、宝鸡和石河子等8个典型城市居民的健康询问调查数据,应用二步模型法和人力资源法分别计算疾病的直接经济负担和间接经济负担。结果 8个典型城市居民慢性病患病率为325.2‰;患病率居于前10位的慢性病依次为高血压(161.7‰)、糖尿病(49.3‰)、冠心病(16.2‰)、脑血管病(10.8‰)、慢性胃肠炎(7.3‰)、慢性阻塞性肺部疾病(6.3‰)、类风湿性关节炎(6.1‰)、椎间盘疾病(4.8‰)、恶性肿瘤(3.6‰)和胆结石胆囊炎(3.6‰),上述疾病患者的年平均疾病经济负担依次为2 677、4 726、7 825、21 688、6 341、8 843、8 871、15 448、60 401和7 443元;各类慢性病均以直接医疗费用经济负担为主,且疾病经济负担构成不同,其中高血压和糖尿病自我医疗药品费用分别占直接医疗费用的55.0%和57.9%,而冠心病、脑血管病、慢性阻塞性肺部疾病、恶性肿瘤和胆结石胆囊炎住院费用所占比例均>50%。结论典型城市居民的主要慢性病为高血压、糖尿病和冠心病;慢性病对个人和家庭经济影响巨大,应将健康纳入所有政策以降低其巨额经济负担。Objective To analyze the prevalence of non-communicable diseases （NCDs） and the average annual economic burden of patients of top 10 NCDs. Methods Data were collected through household survey in 2011 in 8 cities including Hangzhou, Hefei, Wuhan, Chengdu, Wuxi, Tongling, Baoji, and Shihezi. Two-step model and human capital ap proach was used to measure the direct and indirect economic cost of NCDs. Results The prevalence of NCDs was 325.2‰, and the top ten NCDs were hypertension（ 161.7‰）, diabetes （49. 3‰）, coronary heart disease （49. 3‰）, cere brovascular diseases （ 10. 8 ‰）, chronic gastroenteritis （ 7.3 ‰）, chronic obstructive pulmonary disease （ 6. 3 ‰）, rheuma toid arthritis （6. 1‰）, lumbar disc disease （4. 8‰）, malignant tumor （ 3.6%~）, and gallstone cholecystitis （3.6‰）. The total average annual economic burden of the patients with the diseases were 2 677,4 726,7 825,21 688,6 341,8 843, 8 871,15 448,60 401 ,and 7 443 RMB Yuan. The major part of the disease burden was direct medical expenditure. The structures of the disease burdens varied. The self-treatment drug expenditure accounted for 55.0% and 57.9%, respec tively, of direct economic cost of hypertension and diabetes, and for coronary heart disease, cerebrovascular disease, chro nic obstructive pulmonary disease, malignant tumor and gallstone cholecystitis, the main expenses were inpatient services, accounting for over 50% of direct economic cost. Conclusion NCDs, especially cerebrovascular diseases and cancer, caused serious negative influences on the patients and their families. To reduce the heavy economic burden of NCDs needs involvement of all citizens and the implementation of health policies.

关 键 词：慢性非传染性疾病(慢性病) 患病率 疾病经济负担 

分 类 号：R197.1[医药卫生—卫生事业管理]