云南省农村居民糖尿病的疾病经济负担及其影响因素分析  

Economic burden of diabetes and its influencing factors among rural residents in Yunnan Province

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作  者:刘岚 吴霞 刘杜丽 余孜孜 李熙敏 阮春怡 蔡乐 LIU Lan;WU Xia;LIU Du-li;YU Zi-zi;LI Xi-min;RUAN Chun-yi;CAI Le(School of Public Health,Kunming Medical University,Kunming,Yunnan 650500,China)

机构地区:[1]昆明医科大学公共卫生学院,云南昆明650500

出  处:《现代预防医学》2024年第19期3545-3550,共6页Modern Preventive Medicine

基  金:国家自然科学基金(72064026);云南省科技厅-昆明医科大学联合专项重点项目(202401AY070001-027)。

摘  要:目的 分析云南省农村糖尿病患者的疾病经济负担及其影响因素,为制定减轻其疾病经济负担的策略提供科学参考。方法 运用多阶段分层随机抽样,选取7 536名≥35岁云南省农村居民开展问卷调查和体格检查,采用直接法测算糖尿病的直接经济负担,采用人力资本法测算间接经济负担,并应用结构方程模型分析其影响因素。结果 调查人群糖尿病的患病率为8.28%,其中男性8.28%,女性8.28%;汉族的糖尿病患病率高于少数民族,家庭年人均收入高者的糖尿病患病率高于家庭年人均收入低者(P<0.05)。糖尿病患者的人均疾病经济负担为11 022(IQR:11 944)元,包括人均直接经济负担10 559(IQR:11 768)元,占95.80%,人均间接经济负担463(IQR:398)元,占4.20%。结构方程模型分析结果显示,住院情况、误工情况、门诊医疗机构级别、年龄、民族和中心性肥胖均对糖尿病患者的疾病经济负担产生直接影响,其标准化路径系数分别为0.79、0.24、0.09、0.17、0.19、0.14;住院情况中影响较大的是住院天数,标准化路径系数为0.69;误工情况中影响较大的是误工天数,标准化路径系数为0.14。结论 云南省农村糖尿病患者的疾病经济负担较重,加强对高龄、少数民族和中心性肥胖糖尿病患者的规范管理,以及减少患者的住院天数和降低就诊医疗机构级别有助于减轻其疾病经济负担。Objective To analyze the economic burden of diabetes among rural patients in Yunnan Province and its influenc-ing factors,providing a scientific reference for developing strategies to alleviate this burden.Methods A multi-stage stratified random sampling method was employed to select 7536 rural residents aged 35 and above in Yunnan Province for a question-naire survey and physical examination.The direct economic burden of diabetes was calculated using the direct method,while the indirect economic burden was assessed using the human capital approach.A structural equation model was used to ana-lyze the influencing factors.Results The prevalence of diabetes in the surveyed population was 8.28%,with both males and females showing a prevalence of 8.28%.The diabetes prevalence among the Han ethnic group was higher than that of minori-ty groups,and those with higher annual per capita household income had a higher prevalence of diabetes compared to those with lower income(P<0.05).The average economic burden of disease per diabetes patient was 11022(11944)yuan,com-prising an average direct economic burden of 10559(11768)yuan(accounting for 95.80%)and an average indirect eco-nomic burden of 463(398)yuan(accounting for 4.20%).The results of the structural equation model analysis indicated that hospitalization status,work absenteeism,the level of outpatient medical institutions,age,ethnicity,and central obesity all had a direct impact on the economic burden of disease for diabetes patients,with standardized path coefficients of 0.79,0.24,0.09,0.17,0.19,and 0.14,respectively.Among hospitalization factors,the number of hospitalization days had the most signif-icant impact,with a standardized path coefficient of 0.69;in terms of work absenteeism,the number of absentee days was the most influential,with a standardized path coefficient of 0.14.Conclusion The economic burden of disease for diabetes pa-tients in rural Yunnan Province is substantial.Strengthening standardized management for elderly patients,ethnic minorities,and tho

关 键 词:糖尿病 疾病经济负担 影响因素 农村 

分 类 号:R587.1[医药卫生—内分泌]

 

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