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目的研究慢性乙型病毒性肝炎(慢性乙肝)相关疾病患者经济负担,探讨影响经济负担的相关因素。方法对宁波市630例慢性乙肝相关疾病住院患者进行问卷调查,出院后查阅病历,摘录住院费用并计算过去一年的直接费用。分别以直接医疗费用、直接非医疗费用和直接费用为应变量建立逐步多元线性回归,筛选影响费用的因素。结果宁波市平均1例慢性乙肝相关疾病患者年直接医疗费用、直接非医疗费用和直接费用分别为61 606.78、3 532.73和65 139.51元。直接费用原发性肝癌最高,为123 571.78元,其余依次为慢性重型乙肝93 278.65元,肝硬化82 467.99元,慢性乙肝21 824.31元。直接医疗费用和直接非医疗费用平均比值为17.44,原发性肝癌、肝硬化、慢性重型乙肝和慢性乙肝依次为19.17、15.52、21.62和17.02。患者年均直接费用是患者个人年收入的1.75倍,家庭收入的1.02倍。患者职业、合并其他疾病、出院诊断分类和个人年收入等因素均分别是直接费用(包括直接医疗费用和直接非医疗费用)的相关因素。结论宁波市乙肝相关疾病患者经济负担沉重。直接医疗费用大于直接非医疗费用;随着疾病的加重,直接医疗费用增加。
Objective To study the economic burden of patients with chronic hepatitis B (CHB) -related diseases and to explore the relevant factors that affect the economic burden. Methods A total of 630 inpatients with chronic hepatitis B related diseases in Ningbo City were surveyed. After discharge, medical records were reviewed and hospital expenses were extracted and the direct costs of the past year were calculated. Directly medical costs, direct non-medical expenses and direct costs as variables to establish a step-by-step multiple linear regression, screening factors affecting costs. Results The average annual direct medical costs, direct non-medical expenses and direct costs of 1 case of chronic hepatitis B-related diseases in Ningbo were 61 606.78, 3 532.73 and 65 139.51 yuan respectively. The direct cost of primary liver cancer is the highest, 123 571.78 yuan, the rest followed by chronic hepatitis B 93 278.65 yuan, cirrhosis 82 467.99 yuan, chronic hepatitis B 21 824.31 yuan. The direct medical costs and direct non-medical expenses average ratio of 17.44, primary liver cancer, liver cirrhosis, chronic severe hepatitis B and chronic hepatitis B were 19.17,15.52,21.62 and 17.02. The annual average direct costs of patients is 1.75 times the patient’s annual income, 1.02 times the family income. Factors such as occupational status, other diseases associated with other diseases, diagnostic classification of discharges and annual personal income are the relevant factors of direct costs (including direct medical costs and direct non-medical expenses). Conclusion Hepatitis B-related diseases in Ningbo have a heavy financial burden. Direct medical costs are greater than direct non-medical expenses; as the disease aggravates, direct medical costs increase.