中国慢性非传染性疾病经济负担研究

目的了解中国慢性非传染性疾病经济负担及其变化趋势。方法依据1993年、2003年国家卫生服务调查和卫生部常规死因登记报告系统等数据,利用二步模型法和人力资源法分别测算疾病直接经济负担、间接经济负担和总经济负担,并进行分类统计。结果1993年中国慢性非传染性疾病经济负担为1963.44亿元,占全部疾病总经济负担的58.84/,占GDP的5.67/;2003年中国慢性非传染性疾病经济负担达到8580.54亿元,占全部疾病总经济负担的71.45/,占GDP的7.31/。居慢性非传染性疾病总经济负担前5位的疾病是恶性肿瘤、脑血管疾病、高血压、其他类型心脏病、冠心病,其总经济负担合计为3393.53亿元,占慢性非传染性疾病总经济负担的39.55/;占全部疾病总经济负担合计的28.25/。人口老龄化导致明显“疾病堆积”现象。结论慢性非传染性疾病经济负担巨大且以高于GDP增长的速度增长,成为我国主要的疾病经济负担;恶性肿瘤、脑血管疾病、高血压、其他类型心脏病、冠心病是导致慢性非传染性疾病经济负担的主要原因;要从宏观经济和社会发展上警惕“疾病堆积”和“人口红利”,减少对将来社会带来的双重影响。

The Study of Economic Burden of Chronic Non-communicable Diseases in China

Objective To know the economic burden of chronic non-communicable diseases in China and its trend. Methods Using Two-step Model and Human Capital Approach to measure the direct, indirect and total economic cost of chronic non-communicable diseases separately and to sum up by classification according to the data from National Health Service Surveys in 1993 & 2003 and the National Routine Vital Registration System. Results In 1993, the economic burden of chronic non-communicable diseases in China was 196.344 billion RMB, accounting for 58.84% of the total economic burden of all diseases and 5.67% of GDP. In 2003, the economic burden of chronic non-communicable diseases in China was 858.054 billion RMB, accounting for 71.45% of the total economic burden of all diseases and 7.31% of GDP. The leading five orders of chronic non-communicable diseases in China were malignancy, cerebrovascular disease, hypertension, other types of heart diseases and coronary heart disease, the total economic burden of them was 339.353 billion RMB, accounting for 39.55% of the total economic burden of all chronic non-communicable diseases and 28.25% of the total economic burden of all diseases. Aging of population led to a distinct phenomenon called "diseases accumulation". Conclusion The economic burden of chronic non-communicable diseases is enormous, and its increasing speed is higher than that of GDP, which makes a dominating contribution to the economic burden of all diseases in China. Malignancy, cerebrovascular disease, hypertension, other types of heart diseases and coronary heart disease are the primary impetus to the economic burden of chronic non-communicable diseases. From the aspects of macroeconomic and social development, we should maintain sharp vigilance on the double effects of diseases accumulation and the decrease of population dividend on the society.