南京市尘肺病患者直接经济负担及其影响因素分析  

Direct economic burden and influencing factors of pneumoconiosis patients in Nanjing

作　　者：汤玉华 季晓庆 董秋 TANG Yuhua;JI Xiaoqing;DONG Qiu(Nanjing Prevention and Treatment Center for Occupational Diseases,Nanjing,Jiangsu 210042,China)

机构地区：[1]南京市职业病防治院,江苏南京210042

出　　处：《职业卫生与应急救援》2025年第1期27-30,86,共5页Occupational Health and Emergency Rescue

基　　金：江苏省卫生健康委医学科研项目(Z2020047);南京市医学科技发展项目(YKK16219)。

摘　　要：目的描述南京市尘肺病患者2019年直接经济负担,并分析其影响因素,为制定相关的防治策略提供依据。方法基于2019年南京市尘肺病随访基线资料对1290名尘肺病患者当年的直接经济负担(住院费用、门诊费用、总费用)进行了调查,并分析影响医疗费用的因素。结果1290名尘肺病患者初次诊断年龄中位数(第25、75百分位数)为50(45,56)岁,接害工龄为24(18,29)年;人均住院费用为1.44(0.81,3.30)万元,人均门诊费用为1.54(0.60,5.49)万元,人均总费用为2.13(0.87,6.27)万元。多因素分析显示,尘肺患者的门诊费用、总费用与患者初诊年龄、接尘工龄、尘肺病期别存在关联。从门诊费用上来看,相比水泥尘肺患者,矽肺、煤工尘肺、其他类型尘肺、电焊工尘肺、铸工尘肺患者的门诊费用分别增加0.854万、1.258万、0.805万、0.633万、0.857万元(以对数转换后数值计);贰、叁期患者门诊费用比壹期增加0.380万元(P<0.01);初诊年龄每增加1岁,门诊费用增加0.011万元(P<0.05),接害工龄每增加1年,门诊费用增加0.014万元(P<0.01)。从总费用上看,相比水泥尘肺患者,矽肺、煤工尘肺、其他类型尘肺、铸工尘肺患者的门诊费用分别增加0.630万、0.940万、0.553万、0.628万元(以对数转换后数值计);贰、叁期患者总费用比壹期增加0.432万元(P<0.01);初诊年龄每增加1岁,总费用增加0.018万元(P<0.01),接害工龄每增加1年,总费用增加0.010万元(P<0.05)。结论人均门诊费用、住院费用、总费用均处在较高的水平,煤工尘肺患者的经济损失问题较为突出,较高初诊年龄、接尘工龄、尘肺期别的患者会带来更高的直接经济负担。相关部门应加大对尘肺病患者救治的力度,保障尘肺病患者的权益,最大程度减轻尘肺病患者的医疗负担。Objective To describe the direct economic burden of pneumoconiosis patients in Nanjing in 2019 and analyze the influencing factors to provide a basis for formulating relevant prevention and treatment strategies.Methods Based on the baseline data of pneumoconiosis patients followed up in Nanjing in 2019,the direct economic burden(hospitalization costs,outpatient costs,total costs)of 1290 pneumoconiosis patients in that year was investigated,and the factors influencing medical costs were analyzed.Results The median and 25th,75th percentiles(P25,P75)of age at initial diagnosis of 1290 pneumoconiosis patients was 50(45,56)years,and the median time of occupational dust exposure was 24(18,29)years.The median per capita hospitalization cost was ￥14400(￥8100,￥33000),the median per capita outpatient cost was￥15400(￥6000,￥54900),and the median per capita total cost was ￥21300(￥8700,￥62700).Multivariate analysis showed that outpatient costs and total costs were associated with the patients’age at initial diagnosis,the time of occupational dust exposure,and the stage of pneumoconiosis.Compared with cement pneumoconiosis patients,the outpatient costs of silicosis,coal workers’pneumoconiosis,the other types of pneumoconiosis,electric welders’pneumoconiosis,and casting workers’pneumoconiosis patients increased by ￥8540,￥12580,￥8050,￥6330,and ￥8570(in terms of logarithmically transformed values).Outpatient costs of patients at stage Ⅱ and stage Ⅲ were￥3800 higher than patients at stage I(P<0.01);for each additional year of age at initial diagnosis,outpatient costs increased by￥110(P<0.05),and for each additional year of occupational dust exposure time,outpatient costs increased by ￥140(P<0.01).In terms of total costs,compared with cement pneumoconiosis patients,the total costs of silicosis,coal workers’pneumoconiosis,other types of pneumoconiosis,and casting workers’pneumoconiosis patients increased by ￥6300,￥9400,￥5530,and ￥6280(in terms of logarithmically transformed va

关 键 词：尘肺病 直接经济负担 住院费用 门诊费用 

分 类 号：R135.2[医药卫生—劳动卫生]