广州市手足口病不同分型门诊患者疾病经济负担分析  

Economic burden of outpatients with different subtypes of HFMD in Guangzhou

作　　者：汪慧[1] 蒋书琴 陈纯[1] 鲁影[1] 王大虎[1] 李美霞[1] 邹晓妮[3] 王振虎 刘媛媛 赵文恒 罗雷 WANG Hui;JIANG Shu-qin;CHEN Chun;LU Ying;WANG Da-hu;LI Mei-xia;ZOU Xiao-ni;WANG Zhen-hu;LIU Yuan-yuan;ZHAO Wen-heng(Department of Infectious Disease Prevention and Control,Guangzhou Center for Disease Control and Prevention,Guangzhou,Guangdong 510440,China)

机构地区：[1]广州市疾病预防控制中心传染病预防控制部,广东510440 [2]广东药科大学 [3]广东省妇幼保健院 [4]北京中医药大学 [5]南方医科大学 [6]不详

出　　处：《现代预防医学》2022年第1期152-157,共6页Modern Preventive Medicine

基　　金：广州市卫生健康科技项目(20191A011062)。

摘　　要：目的了解广州市手足口病(Hand,foot,and mouth disease,HFMD)不同分型患者疾病经济负担情况及其影响因素。方法通过调查问卷和查阅病例资料获取患者人口学信息以及在就医过程中产生的直接、间接和无形费用,比较不同病原体确诊病例的社会经济负担。结果共纳入HFMD门诊患者419例。OEV型174例(41.5%),EV-71型133例(31.7%);CV-A16型71例(16.9%);无实验室分型41例(9.8%)。HFMD门诊患者总费用2123.0(1142.6,5050.3)元,其中直接费用726.6(439.8,953.4)元,直接医疗费用620.0(354.1,847.9)元,直接非医疗费用75.0(25.0,125.0)元,无形费用500.0(500.0,4000.0)元。不同分型HFMD患者的直接费用、直接医疗费用、无形费用、总费用差异有统计学意义(z=183.871、2.052、8.069、14.308,P<0.05),EV-71型直接费用、直接医疗费用较CV-A16型、其他肠道疾病低,但是无形费用最高;CV-A16型直接费用、直接医疗费用最高。病程、患病类型对直接费用有影响(z=-2.377、183.81,P<0.05),家庭人均月收入对总费用有影响(z=15.935,P<0.05)。结论HFMD患者家庭承受着沉重的经济负担,EV-71型精神负担重、CV-A16型直接花费高,病程、实验室分型、家庭人均月收入对疾病负担有影响。Objective To understand the economic burden of disease among patients with different subtypes of hand,foot,and mouth disease(HFMD)and its influencing factors during 2018-2019 in Guangzhou,China.Methods Demographic characteristics and the direct,indirect and intangible costs incurred in the process of seeking medical care were collected by questionnaires and case documents,and economic burdens of different HFMD subtypes among children with HFMD were compared.Results 419 patients with HFMD were enrolled,including 174(41.5%)subtype HFMD OEV,133(31.7%)subtype HFMD EV-71,71(16.9%)subtype HFMD CV-A16,and 41(9.8%)had no laboratory subtypes.The total expenses of HFMD outpatients were RMB 2,123.0(1142.6,5050.3),including direct expenses of RMB 726.6(439.8,953.4),direct medical expenses of RMB 620.0(354.1,847.9),direct non-medical expenses of RMB 75.0(25.0,125.0)and intangible expenses of RMB 500.0(500.0,4000.0).There were significant differences in direct costs,direct medical costs,intangible costs and total costs among HFMD patients with different subtypes(z=183.871,2.052,8.069,14.308,P<0.05).The direct costs and direct medical costs of EV-71 were lower than those of CV-A16 and other intestinal diseases,but the intangible costs were the highest.CV-A16 type had the highest direct cost and direct medical cost(z=-2.377,183.81,P<0.05).Duration and type of disease affected the direct cost.The per capita monthly income of the family had an effect on the total cost(z=15.935,P<0.05).Conclusion Families of patients with HFMD bear heavy economic burden.The EV-71 has a heavy mental burden and the CV-A16 has a high direct cost.The course of disease,laboratory type and per capita monthly income of family have an impact on the economic burden.

关 键 词：手足口病 疾病经济负担 肠道病毒 儿童传染病 

分 类 号：R725.1[医药卫生—儿科] R1[医药卫生—临床医学]