海南垦区5岁以下儿童手足口病经济负担调查分析

目的了解海南垦区2011-2012年5岁以下儿童手足口病病例的经济负担,为科学制定手足口病防治策略,合理配置卫生资源提供依据。方法采用回顾性调查的方法对海南垦区5岁以下儿童手足口病病例的经济负担进行横断面调查。结果 （1）门诊患者的总费用合计为1.11×106元,每例患者的总费用最低为269.00元,最高为5 700.00元,平均每例患者的总费用（1 378.00±1 514.54）元。直接医疗费用、直接非医疗费用和间接损失的费用,平均数分别为（687.08±1 162.26）元、（286.96±608.14）元、（406.95±302.58）元。在直接医疗费用中,托幼儿童与散居儿童间差异有统计学意义（Z=4.955,P〈0.001）,性别、年龄、病情间差异均无统计学意义（P〉0.05）。在直接非医疗费用中,病情间差别有统计学意义（Z=84.141,P〈0.001）。在间接损失费用中,除年龄间差异无统计学意义（Z=1.096,P〉0.05）,其他差异均有统计学意义（P〈0.05）。（2）每例患者住院的总费用最低为794.00元,最高为53 500.00元,平均每例患者的总费用（3 350.50±2 714.20）元。直接医疗费用、直接非医疗费用和间接损失的平均数分别为（2 340.00±2 015.00）元、（1 44.00±5 56.00）元、（407.00±483.00）元。在直接医疗费用、间接费用、间接损失费用,除病情外（P〈0.001）,性别、职业间、年龄间差异均无统计学意义（P〉0.05）。（3）住院患者的就诊次数,一次门诊所占比例最高为78.44%,第一次就诊医院以县级医院为主,所占比例53.7%。结论海南垦区手足口病经济负担较重,仍然存在部分病例误诊的情况,第一次就诊医院以县级医院为主,其次是市级医院。因此,积极做好手足口病预防控制工作,患病进行规范诊疗,切实降低发病率,才能有效减轻疾病对社会和家庭的经济负担。

Investigation on the financial burden of HFMD of the under 5-year-old children in Hainan Reclamation area.

Objective To investigate the financial cost of the HFMD in the children under 5-year-old from 2011 to 2012 in Hainan Reclamation area, and to provide the basis for making the control strategies of the HFMD sci- entifically and allocating the health resources reasonably. Methods Using the retrospective survey method, with cross-sectional survey way, to investigate the financial cost of the HFMD of the under 5-year-old children in Hainan Reclamation area. Results （1） The total cost was 1.11 x 10~yuan in the outpatient, the lowest total cost was 269.00 yu- an, the highest total cost was 5 700.00 yuan, and the average total cost of each patient （1 378.00 ＋ 1 514.54） yuan. The av- erage of direct medical costs, direct non-medical costs and indirect costs of loss were （687.08~ 1 162.26） yuan, （286.96~ 608.14） yuan, and （406.95＋302.58） yuan, respectively. Preschool children and children scattered in direct medical costs, the difference was statistically significant （Z--4.955, P〈0.001）, and the differences between gender, age and con- dition were not statistically significant. In direct non-medical costs, the difference among the condition was statistical- ly significant （Z=84.141, P〈0.001）. In indirect loss costs, the difference except age was not statistically significant, the other were statistically significant （/〈0.05）. （2） The lowest total cost was 794.00 yuan of patients hospitalized, the highest total cost was 53 500, 00 yuan, and the total cost of each patient was （3 350.50 ~- 2 714.20） yuan. Average di- rect medical costs, direct non-medical costs and indirect losses were （2 340.00 ~2015.00） yuan, （144.00a：556.00） yuan, and （407.00~483.00） yuan, respectively. In direct medical costs, indirect costs, indirect costs of loss, except the dis- ease, the difference between gender, occupation, and age were not statistically significant. （3） Inpatients on the number of outpatient proportion up to 78.44%, the first visiting hospital wass the county hospital, with the proportion of 53.7%. Conclusion The financial cost of the HFMD is higher in Hainan Reclamation area, and there are still some cases of misdiagnosis in the first visiting hospitals.