山东省2型糖尿病患者自付医疗费用和疾病经济风险现状分析

目的:分析山东省2型糖尿病患者的自付医疗费用和疾病经济风险状况,探索影响患者疾病经济风险的相关因素。方法:于2017年,采用多阶段分层随机抽样,开展问卷调查;测算患者的致贫性卫生支出发生率和贫困程度;采用logistic回归分析,探索糖尿病患者疾病经济风险发生的相关因素。结果:2型糖尿病患者的年均自付医疗费用为2 362.00元。患者致贫性卫生支出发生率为30.50%,贫困平均缺口为5 022.00元。Logistic回归结果显示,患病时间长、患有并发症、使用胰岛素治疗是致贫发生的危险因素;而患者人均家庭收入高和不使用药物治疗是致贫的保护因素。讨论与建议:山东省2型糖尿病患者面临严峻的疾病经济风险;建议加强对糖尿病患者的管理,有效提高门诊慢病的覆盖范围和补偿强度,加大对重点人群的健康扶贫力度。

Analysis of the status of self-paid medical expenses and disease economic risks among T2MD patients in Shandong province

Objective:To analyze the self-paid medical expenses, impoverishing health expenditure and its influencing factors on economies of Type 2 Mellitus Diabetes (T2MD) patients in Shandong province, China. Methods:In 2017, a multi-stage stratified random sampling was used to conduct a questionnaire survey on these patients in person. From the survey, the incidence of expenditure-induced poverty and its levels were measured, and logistic regression analysis was used to explore the factors influencing economies of T2MD diabetic patients. Results:The annual average self-financed medical expenses for T2MD patients was 2 362RMB, and the incidence of health expenditure-induced poverty was 30.50% with an average poverty gap increase of 5 022RMB. The logistic regression results showed that longer duration of disease, having complications, and the insulin therapy were the risk factors for impoverishment of diabetic patients. The higher per capita household income and not using medicines were factors to protect people from impoverishment. Conclusions:Patients with Type 2 Mellitus Diabetes in Shandong province are in considerably high economic risk induced by expenses they pay themselves for diagnosing the T2MD diabetes. Therefore, it is suggested to pay more attention to the T2MD at high economic risk and to strengthen the management of T2MD patients, efficiently improve the coverage and compensation intensity of chronic diseases expenses, and tightly follow-up the healthcare measures with target populations.