安徽省系统性红斑狼疮病人年均直接经济负担及影响因素分析

目的分析SLE病人年均直接经济负担及影响因素，为减轻病人疾病经济负担提供参考依据。方法调查2019年1-5月安徽省2所三级甲等医院病程≥1年的SLE住院病人，计算其过去1年年均直接经济负担，并运用多元对数线性回归模型分析年均直接经济负担的影响因素。结果77例SLE住院病人的年直接经济负担中位数15520.0元，5.2%（4/77）的病人年直接经济负担超过他们的年家庭收入；以年均直接经济负担的对数为应变量，进行多元线性回归分析，结果显示，城镇医疗保险和新农村合作医疗保险病人年均直接经济负担均高于自费病人（P < 0.01），疾病活动期与合并狼疮肾炎均增加病人年均直接经济负担（P < 0.01），病人病程越长，年均直接经济负担越低（B=-0.09，P < 0.01）。结论安徽省SLE病人年均直接经济负担沉重，有必要进一步完善医疗保险补偿机制，规范病人就医，提高全民的参保意识和参保比例，同时积极治疗并发症。

Analysis of the annual direct economic burden and influencing factors of patients with systemic lupus erythematosus in Anhui province

ObjectiveTo analyze the direct economic burden and its influencing factors of patients with systemic lupus erythematosus(SLE), and provide the reference basis for reducing the economy burden of patients.MethodsThe last year annual direct economic burden in SLE inpatients with disease duration ≥ 1 year in two top three hospitals in Anhui during January to May 2019 was investigated, and a multiple log-linear regression was used to analyze the influencing factors of direct economic burden.ResultsThe median of the annual direct economic burden in 77 SLE inpatients was 15 520.0 Yuan, and the annual direct economic burden of 5.2%(4/77) patients exceeded their annual family income.When the logarithm of the annual direct economic burden was taken as the dependent variable, the results of multiple linear regression showed that the direct economic burden of urban medical insurance and new rural cooperative medical insurance patients were higher than that of self-paid patients(P < 0.01), and the disease activity stage and combined lupus nephritis could increase the annual direct economic burden of patients(P < 0.01).The longer the course of illness was, the lower the annual direct economic burden was(B=-0.09, P < 0.01).ConclusionThe direct economic burden of patients with SLE in Anhui province is heavy.It is necessary to improve the medical insurance compensation mechanism, raise the awareness and proportion of people participating in insurance programs, actively treat complications.