云南省农村居民四种主要慢性病的疾病经济负担研究

目的 分析云南省农村居民高血压、糖尿病、冠心病和脑卒中的疾病经济负担。方法 采用分层随机抽样方法于2015年1月～9月对云南省农村抽取的4 979名≥35岁居民进行问卷调查和体格检查，采用人力资本法结合伤残调整生命年（disability adjusted life years，DALY）估算四种慢性病的疾病经济负担。结果 云南省农村居民高血压、糖尿病、冠心病和脑卒中的患病率分别为35.3%、9.9%、3.8%和1.7%；DALY值分别为2.4/千人年、5.2/千人年、23.5/千人年和21.1/千人年，其中以冠心病的每千人口DALY值最高。四种慢性病的人均疾病经济负担分别为6 667.4元、9 126.1元、9 270.0元和16 187.2元，其中男性分别为7 093.8元、9 510.4元、12 060.9元和19 262.4元，女性分别为6 250.7元、8 554.9元、4 849.4元和9 030.6元；男性四种慢性病的人均疾病经济负担均高于女性（均有P<0.05）。四种慢性病的总疾病经济负担分别为108 185.2百万元、41 529.5百万元、16 192.0百万元和12 649.0百万元。结论 高血压、糖尿病、冠心病和脑卒中对云南省农村居民造成了沉重的经济负担，应采取相应措施降低其导致的疾病经济负担。

Analysis of economic burden of four major chronic diseases in rural Yunnan Province

Objective To estimate the economic burden of four major chronic diseases (hypertension, diabetes, coronary heart disease and stroke) in rural Yunnan Province. Methods Multistage stratified random sampling method was used to select representative samples of 4 979 rural residents aged 35 years and over in Yunnan Province during the period of January to August of 2015. Human capital approach combined with disability adjusted life years (DALY) were applied to measure economic burden of the four chronic diseases. Results In the study region, the prevalence of hypertension, diabetes, coronary heart disease(CHD)and stroke was 35.3%, 9.9%, 3.8% and 1.7%, respectively, and the DALY per 1 000 population due to hypertension, diabetes, CHD and stroke was 2.4, 5.2, 23.5 and 21.1, respectively. Mean unit economic burden of the four chronic diseases was 6 667.4 Yuan, 9 126.1 Yuan, 9 270.0 Yuan and 16 187.2 Yuan, respectively. Mean unit economic burden of the four chronic diseases was 7 093.8 Yuan, 9 510.4 Yuan, 12 060.9 Yuan and 19 262.4 Yuan for male, whereas 6 250.7 Yuan, 8 554.9 Yuan, 4 849.4 Yuan and 9 030.6 Yuan for female, respectively. The total economic burden of the four chronic diseases was 108 185.2 million Yuan, 41 529.5 million Yuan, 16 192.0 million Yuan and 12 649.0 million Yuan, respectively. Males had higher mean unit economic burden for each of the four diseases than those for females (all P<0.05). Conclusions Hypertension, diabetes, coronary heart disease and stroke cause significant economic impacts on society in rural Yunnan Province. Effective measures are needed to reduce the economic burden of the four diseases.