中国人群2002年吸烟和被动吸烟的现状调查

目的描述2002年中国人群吸烟、戒烟和被动吸烟的流行水平及在不同教育水平、职业和地区的分布特点，判断烟草流行的变化趋势。方法在145个疾病监测点中通过多阶段分层随机抽样，使用调查表人户调查，完成调查16407人，其中有16056人合格记录用于分析。采用总吸烟率、现在吸烟率、吸烟者日平均吸烟量、吸烟花费、戒烟率等指标，根据2002年普查人口进行加权计算。结果男性吸烟率为66．0％，女性吸烟率为3．08％，与1996年结果比较，人群吸烟率下降1．8％，15～24岁人群吸烟率上升，15岁以上吸烟者达到3．5亿人，较1996年增加3000万人。男性吸烟者水平大致相等，女性吸烟的地区差别更明显，东北、华北等地女性吸烟率依然很高。戒烟率增加，从1996年的9．42％上升到现在的11．5％，意味着增加了1000万戒烟者，但不打算戒烟者依然占了绝大多数，达到74％。人均吸烟量基本不变，为14．8支／日，吸烟者平均每日花费2．73元，但不同人群差异很大，最高和最低者相差15倍。被动吸烟暴露并没有大的改善，1996年和2002年两次调查结果几乎相等，人群中被动吸烟暴露水平分别为53％和52％。人们对烟草危害健康的知识增加，但西部地区人们的知识贫乏。60％以上的人支持公共场所禁止吸烟，45％支持禁止烟草广告，但地区差异依然很大。结论中国男性烟草使用的流行水平已经达到高峰，目前处在平台期，还没有明显的下降趋势。有关吸烟有害健康知识的传播还远远不够，特别西部地区人群对控烟措施的理解和支持率均不高，中国人群在短时间内烟草流行率不会明显下降，烟草导致的疾病负担在未来30—50年内将成为现实。     

我国2008年归因于吸烟的疾病经济负担研究

目的:估算2008年中国35岁及以上成人归因于吸烟的疾病经济负担。方法:运用流行病学公式计算基于吸烟率的吸烟归因分值,直接经济负担和间接经济负担。主要数据来源于第四次国家卫生服务调查和2008年中国卫生统计年鉴;结果:2008年35岁及以上成人归因于吸烟的经济负担共计22 695 309.7万元,占国内生产总值的0.90%。其中,直接经济负担为4 231 283.7万元,占18.6%;间接经济负担为18 464 026.0万元,占81.4%。用于治疗吸烟有关疾病费用共计3 937 741.2万元,占全国卫生总费用的3.5%。结论:吸烟给中国社会造成了巨大的经济负担,要减轻这个负担需要在未来采取更多更强有力的措施控制烟草危害。     

烟草使用疾病负担研究方法学与应用综述

烟草使用疾病负担分为烟草使用疾病健康寿命损失和烟草使用疾病经济负担两类,疾病健康寿命损失的研究主要采用以吸烟率为基础的直接法和以吸烟影响比为基础的间接法;疾病经济负担主要采用疾病特异法和全病因研究法。笔者对烟草使用疾病负担测算及评价主要采用的方法及指标应用现状进行综述,指出各方法仍存在缺陷,需进一步完善。     

烟草使用疾病负担研究方法进展

目前,烟草使用疾病负担指烟草(口吸、咀嚼和鼻吸,主要指口吸)对人类所造成的健康和寿命损害、经济损失等疾病负担,已成为严重的公共卫生问题之一.深入了解烟草的健康危害及其变化趋势,为持续进行烟草有害健康的教育、制定控烟政策和建立无烟环境等提供信息参考,世界各国一直在进行有关烟草使用疾病负担[1-3]的研究,研究方法众多且各有特点.为了解烟草使用疾病负担研究方法状况,为深入进行烟草使用疾病负担研究提供参考,对国内外烟草使用疾病负担研究方法进展作一综述.     

老年人6种常见慢性病的疾病负担

目的了解我国老年人中脑血管疾病、恶性肿瘤、心脏病、糖尿病、高血压、呼吸系统疾病等6种常见的老年慢性疾病的疾病负担现状。方法通过对国家卫生服务调查数据的分析，采用患病率、死亡率、去死因期望寿命等指标对健康损失进行估计；并计算了这6种疾病的直接经济损失。结果在8811万65岁以上人群中受这6种疾病侵害的老年人在2000万以上。去死因期望寿命计算结果显示，这6种疾病导致的65岁以上老年人期望寿命损失，城市为8．18岁，农村为7．78岁，全国合计为7．86岁，分别占65岁时期望寿命的51．35％，50．82％和50．78％；我国目前这6种慢性病在65岁以上老年人群中造成的直接经济负担约为340亿元人民币，约占2002年我国卫生总费用的6％。结论无论是健康损失还是经济损失，这6种常见慢性疾病导致的疾病负担均是巨大的，将给社会和政府造成巨大的压力。     

中国居民归因于吸烟的疾病直接经济负担分析

目的 分析中国居民因吸烟导致的直接经济负担水平及其分布,为制定相关政策提供依据.方法 利用流行病学方法,使用2018年第六次国家卫生服务调查数据,分析归因吸烟导致的直接经济负担,并对不同年龄组、不同系统疾病的直接经济负担开展分析.结果 2018年归因于吸烟的直接经济负担为826.3亿元,相比2008年的428.0亿元增...     

青少年吸烟行为干预研究进展

据世界卫生组织估计 ,目前全球每年有 3 5 0万人死于与吸烟相关的疾病 ,而大多数人开始吸烟的年龄小于 1 8岁。近年来青少年吸烟率显示出增长的趋势 ,开始吸烟年龄也较以前降低。如果烟草不能得到很好的控制 ,今天的儿童和青少年中将有 2亿 5千万会因使用烟草而提前死亡 (中国 2 1世纪控烟策略研讨会 2 0 0 0 )。因此 ,预防青少年成为未来的吸烟者有非常重要的意义。国内外青少年吸烟行为的流行现况全球青少年吸烟调查美洲地区报告显示 ,1 3～ 1 5岁少年儿童吸烟率达 2 0 %～ 3 9 5 % ;此外 ,还有2 0 %的少年儿童有尝试吸烟倾向[1] 。据WH…     

海宁市道路交通事故原因与疾病负担评价

目的探讨道路交通伤亡事故（简称车祸）原因与疾病负担。方法应用2001年全市车祸现场勘察信息及其相关资料，对车祸的成因、流行特征、人体损伤部位、经济损失情况等进行综合分析研究，并计算平均潜在寿命损失年（YPLL）、潜在工作寿命损失年（WYPLL）和潜在价值寿命损失年（VYPLL）在全死因中的位次。结果2001年海宁市人口车祸发生率188．59／10万、人口死亡率22．48／10万；万车事故发生率151．73、万车死亡率18．10。事故原因分析显示：人的因素占93．1％、其中驾驶员因素占89．4％，主要表现在：不按规定让行、措施不当、疏忽大意、纵向间距不够、违章行驶等；直接经济损失3127万元，平均每宗交通事故2．59万元，车祸导致的人均YPLL、WYPLL、VYPLL位居各类主要死因之首。结论提高驾驶员的综合素质，是预防车祸发生的关键。     

1996年汕头市居民吸烟行为的流行病学调查分析

为了解汕头市居民的吸烟模式,采用全国1996年吸烟调查方案．对该市疾病监测区15—70岁的约1000名居民进行了吸烟行为调查．结果 该区15—70岁人群总吸烟率为39．10％,男性(7197％)高于女性(4．59％);15-19岁组吸烟率最低(12．77％)．55—59岁组吸烟率最高(46.77％),私营企业主吸烟率最高(71．43％)．中学生最低(3.90％);25岁前开始吸烟占80．31％,每天吸烟5—24支占92．0％;戒烟率为15．10％,其中戒烟成功占27.58％;被动吸烟率为60．37％;对吸烟有害健康认知率达87．70％。对被动吸烟及孕妇吸烟危害认知率较低(74.0％、55．2％)。认为该市吸烟率仍然居于高水平,应加强宣传及禁烟法规的执行力度,减少烟草的危害。     

福建省吸烟行为流行病学调查

本文对１９９５年福建省９个疾病监测点的吸烟行为流行病学现状调查进行分析，阐述我省不同人群吸烟水平和行为等状况。结果表明：我省１５－６９岁人群的吸烟率是３５．９４％，其中１５－２０岁青少年吸烟率为６．０７％，２１－６９岁成人吸烟率为３７．９２％；男性吸烟率远高于女性，城市低于农村；平均开始吸烟年龄是２０．８岁；人群戒烟率是１３．９％，而戒烟成功率为５．５％；被动吸烟率为４１．７％。调查结果中１９８４     

中国人乳头瘤病毒感染相关疾病经济负担:系统文献回顾和综合分析

  目的  整合中国内地人乳头瘤病毒(human papilloma virus, HPV)感染相关疾病的成本相关数据,估算中国内地HPV感染相关疾病的经济负担。  方法  以“成本/费用”分别联合HPV感染相关9种疾病即宫颈癌、阴道癌、外阴癌、肛门癌、阴茎癌、口咽部癌、宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)、肛门生殖器疣(anogenital warts,AGW)和复发性呼吸道乳头状瘤(recurrent respiratory papillomatosis,RRP)的名称为关键词,检索PubMed、中国知网等7个数据库2001―2020年发表的针对中国内地患者的文献,摘取各类成本相关数据,并将成本数据按照相应的消费价格指数逐年调整至2020年,估算这9种疾病各自的例均直接医疗成本、直接非医疗成本和间接成本。收集这9种疾病各自的发病率、患病率和HPV归因分数数据,进一步估算2020年中国内地HPV感染相关疾病总经济负担。  结果  最终纳入文献247篇。6种恶性肿瘤的首年例均总成本为58 189~79 567元,随后年年例均总成本为13 025~27 965元。RRP的年例均总成本为41 329元。CIN和AGW的例均总成本为6 452~13 602元。2020年中国内地HPV感染相关疾病所致总经济负担为180.3亿元,其中宫颈癌为96.9亿元。直接医疗成本是经济负担的主要部分,占总成本的70%,其中宫颈癌的直接医疗成本为70.0亿元。  结论  HPV感染相关疾病每年给中国内地造成的经济负担不容忽视,需扩大HPV疫苗接种以减少其经济损失。     

The burden of food related ill health in the UK

STUDY OBJECTIVE: To quantify the burden of ill health in the UK that can be attributed to food (the burden of food related ill health). DESIGN: Review and further analysis of the results of work concerned with estimates of the burden of disease measured as morbidity, mortality, and in financial terms and with the proportion of that burden that can be attributed to food. MAIN RESULTS: Food related ill health is responsible for about 10% of morbidity and mortality in the UK and costs the NHS about 6 billion pounds annually. CONCLUSIONS: The burden of food related ill health measured in terms of mortality and morbidity is similar to that attributable to smoking. The cost to the NHS is twice the amount attributable to car, train, and other accidents, and more than twice that attributable to smoking. The vast majority of the burden is attributable to unhealthy diets rather than to food borne diseases.     

Medical costs of fourteen occupational illnesses in the United States in 1999

OBJECTIVES: This study estimated the annual medical costs associated with 14 occupational illnesses in the United States in 1999. METHODS: National data sets collected by the National Center for Health Statistics, the Health Care Financing Administration, and the Agency for Healthcare Research and Quality were aggregated and analyzed. The cost assessment began with estimates of national health expenditures. These included categories for hospital care, professional services, nursing homes, and medical products, including drugs, administration, public health activities, research and construction. The total disease burden was assessed from estimates of hospital days and number of outpatient visits. The occupational disease burden was assessed by multiplying the total disease burden by a given percentage of the proportionate attributable risk for the disease in question. The occupational burden was then combined with costs for each disease. Adjustments were made for unique inpatient and outpatient costs. RESULTS: In the preferred model, the 14 diseases generated USD 14.5 billion in medical costs in 1999. Roughly USD 10.7 billion was attributed to men and USD 3.8 billion to women. The diseases generating the most costs were as follows: circulatory diseases in the age group 24-64 years (USD 4.7 billion), cancer (USD 4.3 billion), chronic obstructive pulmonary disease (USD 2.2 billion), and asthma (USD 1.5 billion). A sensitivity analysis generated alternative estimates. An upper age limit of 74 years increased the circulatory disease estimate by USD 3.7 billion. The range of the sensitivity analysis was USD 9.6-19.7 billion. CONCLUSION: This study significantly improves over the methodology of previous literature. Our methods were transparent. Occupational illnesses were a major contributor to the total cost of medical care.     

The costs of health damage and productivity losses attributable to cigarette smoking in Germany

Background: Smoking causes significant health damage and mayincur a significant economic burden to society. This study investigatesthe years of potential life lost, the direct medical costs andthe Indirect costs of cigarette smoking in Germany. Methods:Using the concept of attributable risks and the prevalence-basedapproach, smoking-attributable mortality and morbidity werecalculated for 1993. Neoplasms, cardiovascular diseases, respiratorydiseases, perinatal diseases and burn deaths were considered.Attributable risks stem from the literature and were processedin an epidemiological model. Costs were estimated from a societalperspective. Direct costs were mainly calculated based on routineutilization and expenditure statistics and indirect costs werecalculated according to the human capital approach. Results:Twenty-two percent of all male and 5% of all female deaths aswell as 1.5 million years of potential life lost were attributableto smoking. The costs of acute hospital care, in-patient rehabilitationcare, ambulatory care and prescribed drugs were 9.3 billionDEM, of mortality were 8.2 billion DEM and costs due to work-lossdays and early retirement were 16.4 billion DEM (discount rate3%). The total costs added up to 33.8 billion DEM, 415 DEM perinhabitant or 1,599 DEM per current smoker. Sensitivity analysesshowed that including the productivity loss of unpaid work leadsto a strong increase of indirect costs. Conclusions: This studyprovides a conservative estimate of the costs of smoking inGermany. The magnitude is considered sufficient reason to callfor stronger support of cost-effective, smoke-cessation measuresand of anti-smoking policy.     

我国唐氏综合征的疾病经济负担研究

目的:对我国唐氏综合征(简称唐氏)经济负担进行测算,促进唐氏预防和控制策略规划的制定。方法:2004年,课题组对河北省、陕西省和上海市三地唐氏患者的直接照料人进行了入户卫生服务调查。唐氏的经济负担包括直接医疗费用、直接非医疗费用和间接费用(如劳动收入损失)。采用发病率方法,对2003年我国每一新发唐氏病例以及所有新发病例生命周期的经济学负担进行测算。结果:课题组在访谈了222位唐氏患者的直接照料人。从患者家庭角度看,2003年我国每一新发唐氏病例的经济负担是39.00万元,所有新发病例的经济负担达70.00亿元;从社会角度看,每一新发唐氏病例的经济负担是人民币45.00万元,所有新发病例的经济损失达人民币81.40亿元。大多数经济损失归因于间接的劳动收入损失。结论:唐氏患者使家庭和社会承受了巨大的经济负担。因此,亟需对唐氏患者及家庭提供社会支持以降低经济负担,同时,开展产前诊断以预防唐氏显得十分必要。     

Estimates of Annual Medical Costs of Work-related Low Back Pain in Japan

Little is reported regarding economic burden of work-related low back pain except for the United States. In the present study, annual medical cost of work-related low back pain in Japan was calculated based on the treatment fee per day, a total of days of treatment received for low-back pain of all causes, employment rates, and an estimated number of work-related low-back cases. The analysis indicated that, in 2011, the total annual medical cost for work-related low back pain was 82.14 billion yen, consisting of 26.48 and 55.66 billion yen for inpatients and outpatients, respectively. As well as for 2011, the costs were also estimated for 2008, 2005, and 2002. Whereas the total medical costs of work-related low back pain monotonically increased during 2002–2011, the costs for spine disorder (including spondylosis) have also increased in recent years. Work-related low back pain entails a considerable economic burden to Japanese society.     

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。     

Assessment of Total Economic Burden of Chronic Hepatitis B (CHB)-Related Diseases in Beijing and Guangzhou, China

Objective:  To estimate the total annual cost due to Chronic Hepatitis B (CHB)-related diseases imposed on each patient and his/her family in Beijing and Guangzhou, China.
Methods:  Economic burden of CHB-related diseases (CHB, compensated cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma) were examined. A retrospective cohort of 328 patients in Beijing and 271 in Guangzhou were identified to obtain their socioeconomic status, utilization and costs of treatment, and work loss days due to illness with a structured questionnaire. Costs of hospitalization were extracted from databases of two hospitals in Beijing and Guangzhou Social Insurance Information System, respectively. The outpatient expenditure per patient was measured through the rate of outpatient visits and average cost per visit reported by the patients, while the inpatient cost was calculated through annual rate of hospitalization and average expenditure for different types of hospitals. Self medication and direct nonmedical cost were also reported. The Human Capital Approach was employed to measure the work loss cost.
Results:  The total annual cost per patient for CHB, compensated cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma were US$1636, US$2722, US$4611, and US$6615 in Beijing, and US$1452, US$2065, US$4290 and US$6054 in Guangzhou, respectively.
Conclusion:  This study confirms that CHB-related diseases impose a substantial economic burden on patients, families, and the society in China urban areas. The study demonstrates increasing health-care costs related to disease progression and provides useful information on cost of treatment and work loss for different disease states, which can be further utilized in cost-effectiveness evaluation.     

Projections of the costs associated with colorectal cancer care in the United States, 2000-2020

Because of aging trends in the US, the number of prevalent colorectal cancer patients is expected to increase. We projected economic burden to the Medicare program and its beneficiaries through the year 2020. Burden was estimated for the initial phase of care, the period following diagnosis, the last year of life, and the continuing phase. Projected burden was evaluated with varying assumptions about incidence, survival, and costs of care. Estimated costs of care in 2000 in the initial, continuing, and last year of life phases of care were approximately $3.18 billion, $1.68 billion, and $2.63 billion, respectively. By the year 2020 under the 'fixed' current incidence, survival, and cost scenario, projected costs for the initial, continuing, and last year of life phases were $4.75 billion, $2.63 billion, and $4.05 billion. Under the current trends scenario (decreasing incidence, improving survival, and increasing costs), costs were $5.19 billion, $3.57 billion, and $5.27 billion. By the year 2020, estimated costs of colorectal cancer care among individuals aged 65 and older increased by 53% in the fixed scenario and by 89% in the current trends scenario. The future economic burden of colorectal cancer to the Medicare program and its beneficiaries in the US will be substantial.