【摘要】：目的：調(diào)查總結(jié)濟(jì)南地區(qū)2009年支氣管哮喘患者治療花費(fèi)、誤工誤學(xué)數(shù)據(jù)資料,獲得該地區(qū)支氣管哮喘患者的經(jīng)濟(jì)負(fù)擔(dān)狀況,并分析其相關(guān)影響因素,為合理控制支氣管哮喘發(fā)作、降低支氣管哮喘治療費(fèi)用提供合理化建議。 方法：采用橫斷面多級(jí)分層隨機(jī)抽樣,將濟(jì)南地區(qū)居民分成城區(qū)和農(nóng)村兩層,根據(jù)濟(jì)南市公安局提供的行政區(qū)劃和人口信息再逐級(jí)分層,將全部在冊(cè)戶(hù)口并且實(shí)際在本地居住6個(gè)月以上的所有家庭成員作為調(diào)查對(duì)象。參照ISAAC等國(guó)際廣泛認(rèn)可的過(guò)敏性疾病調(diào)查問(wèn)卷及2008年哮喘疾病防治指南制定調(diào)查問(wèn)卷。問(wèn)卷包括初篩問(wèn)卷和專(zhuān)業(yè)問(wèn)卷兩部分。對(duì)問(wèn)卷的問(wèn)題“您曾經(jīng)有過(guò)“哮喘”嗎”或(和)“您曾經(jīng)被醫(yī)生診斷為哮喘嗎”回答“是”,并且對(duì)問(wèn)題“在過(guò)去的任何時(shí)間里,是否有反復(fù)發(fā)作(3次以上)的如下癥狀中的一個(gè)或多個(gè)：發(fā)作性憋氣、喘息或哮喘、咳嗽、胸悶,或出氣時(shí)胸部有鳴笛樣的“哮鳴音”或發(fā)出“嘶嘶”的聲音”,回答“是”且排除其他心肺疾病則診斷為哮喘。調(diào)查采取入戶(hù)面對(duì)面填寫(xiě)問(wèn)卷的方式獲得資料。建立Access數(shù)據(jù)庫(kù),兩次錄入數(shù)據(jù)。依據(jù)濟(jì)南2009年支氣管哮喘調(diào)查資料,結(jié)合當(dāng)年支氣管哮喘患病率,利用直接法和人力資本法,測(cè)算濟(jì)南城市居民和鄉(xiāng)鎮(zhèn)農(nóng)業(yè)人口支氣管哮喘患者的經(jīng)濟(jì)負(fù)擔(dān)。使用SPSS13.0軟件進(jìn)行統(tǒng)計(jì)分析,并運(yùn)用單因素卡方檢驗(yàn)、多因素Logistic回歸等統(tǒng)計(jì)方法,分析影響支氣管哮喘治療費(fèi)用的因素。 結(jié)果：總共接受調(diào)查的人數(shù)為13645人,有效問(wèn)卷數(shù)為13419份,問(wèn)卷合格率為98.3%,其中城市6995人,農(nóng)村6424人,男6571人,女6848人。哮喘患者152例,患病率為1.1%。152名患者的年總直接醫(yī)療費(fèi)用為471504元,人均3102元；總直接非醫(yī)療費(fèi)用為109440元,人均720元,年人均直接經(jīng)濟(jì)負(fù)擔(dān)為3822元。城市和農(nóng)村哮喘患者及其家人年均誤工日分別為10天／年和15天／年,總間接經(jīng)濟(jì)負(fù)擔(dān)為84573元,人均556元。年總經(jīng)濟(jì)負(fù)擔(dān)為665517元,人均4378元。以同年濟(jì)南地區(qū)城市和農(nóng)村居民支氣管哮喘總體患病率1.1%為基礎(chǔ),測(cè)算該地區(qū)支氣管哮喘患者疾病總經(jīng)濟(jì)負(fù)擔(dān)為2.90億元,其中直接經(jīng)濟(jì)負(fù)擔(dān)是2.53億元,間接經(jīng)濟(jì)負(fù)擔(dān)是0.37億元。城鎮(zhèn)哮喘患者年總經(jīng)濟(jì)負(fù)擔(dān)為2.74億元,農(nóng)村哮喘患者年總經(jīng)濟(jì)負(fù)擔(dān)為0.16億元。合并過(guò)敏性鼻炎、患有其他心肺疾病、因哮喘住院、未按照GINA規(guī)范化治療及吸煙指數(shù)是影響濟(jì)南地區(qū)支氣管哮喘經(jīng)濟(jì)負(fù)擔(dān)的主要因素。 結(jié)論：濟(jì)南地區(qū)支氣管哮喘患者經(jīng)濟(jì)負(fù)擔(dān)沉重,吸煙、沒(méi)有按照GINA規(guī)范化治療、住院、合并鼻炎及其他心肺疾病是導(dǎo)致經(jīng)濟(jì)負(fù)擔(dān)增加的主要原因。
[Abstract]:Objective: to investigate and summarize the data of treatment cost and misstudy of bronchial asthma patients in Jinan area in 2009, and to obtain the economic burden of bronchial asthma patients in this area, and to analyze the related influencing factors. In order to control the attack of bronchial asthma reasonably, reduce the cost of treatment of bronchial asthma to provide reasonable suggestions. Methods: according to the administrative division and population information provided by Jinan Public Security Bureau, the residents in Jinan area were divided into two layers: urban area and rural area by cross-sectional multi-level stratified random sampling, and then stratified according to the administrative division and population information provided by Jinan Municipal Public Security Bureau. All family members who have registered accounts and have actually resided locally for more than 6 months are surveyed. Reference to ISAAC and other internationally recognized questionnaire for allergic diseases and asthma disease prevention and treatment guidelines in 2008 to develop questionnaires. The questionnaire includes two parts: primary screening questionnaire and professional questionnaire. To the questionnaire question "have you ever had asthma" or (and) "have you ever been diagnosed with asthma by a doctor" answer "Yes" and at any time in the past, Whether there is one or more of the following symptoms of recurrent attacks (more than three times): paroxysmal choking, wheezing or asthma, coughing, chest tightness, or "whistling" or "hissing" in the chest when out of breath. Answering yes and excluding other cardio-pulmonary diseases is diagnosed as asthma. The survey was conducted by filling out the questionnaire face-to-face. Establish Access database and input data twice. According to the survey data of bronchial asthma in Jinan in 2009, combined with the prevalence rate of bronchial asthma in that year, the economic burden of bronchial asthma patients in Jinan city residents and rural agricultural population was calculated by using direct method and human capital method. The statistical analysis was carried out with SPSS13.0 software, and the factors affecting the treatment cost of bronchial asthma were analyzed by using univariate chi-square test and multi-factor Logistic regression. Results: the total number of people surveyed was 13645, the number of valid questionnaires was 13419, and the qualified rate was 98.3%. Among them, 6995 were in cities, 6424 in rural areas, 6571 in men and 6848 in women. The total annual direct medical expenses were 471504 yuan (3102 yuan), the total direct non-medical expenses were 109440 yuan (109440 yuan), the annual direct economic burden (3822 yuan) was 3822 yuan (per capita) in 152 patients with asthma, the prevalence rate was 1.1%, and the annual direct medical expenses were 471504 yuan, 3102 yuan per person, 109440 yuan and 3822 yuan respectively. The average annual delayed working days of asthma patients and their families in urban and rural areas were 10 days / year and 15 days / year, respectively. The total indirect economic burden was 84573 yuan, with a per capita of 556 yuan. The annual total economic burden is 665517 yuan, per capita 4378 yuan. On the basis of 1.1% of the total prevalence of bronchial asthma among urban and rural residents in Jinan in the same year, the total economic burden of bronchial asthma in this area is estimated to be 290 million yuan, of which the direct economic burden is 253 million yuan. The indirect economic burden is 37 million yuan. The annual total economic burden of asthma patients in urban and rural areas was 274 million yuan and 16 million yuan respectively. The main factors affecting the economic burden of bronchial asthma in Jinan area were allergic rhinitis, other cardio-pulmonary diseases, hospitalization of asthma, non-standardized treatment according to GINA and smoking index. Conclusion: the economic burden of bronchial asthma patients in Jinan area is heavy, smoking, no standardized treatment according to GINA, hospitalization, rhinitis and other cardio-pulmonary diseases are the main reasons leading to the increase of economic burden.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R562.25

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