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我国6省7家县级公立医院高血压患者的卫生经济负担及影响因素研究
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| 篇名： | 我国6省7家县级公立医院高血压患者的卫生经济负担及影响因素研究 |
| TITLE： | Study on the Health Economic Burden of Hypertension Patients and Its Influential Factors in 7 County-level Public Hospitals from 6 Provinces of China |
| 摘要： | 目的：探讨我国县级地区高血压患者的卫生经济负担情况及其影响因素。方法：采用方便抽样法，对我国河北、山东、山西等6省7家县级公立医院的高血压患者进行问卷调查，以“医药卫生支出超过家庭收入的10％”的标准界定灾难性卫生支出，分析灾难性卫生支出发生率、平均差距和相对强度，并利用多因素Logistic回归模型分析导致灾难性卫生支出的影响因素。结果：共发放问卷1378份，回收有效问卷925份，问卷有效率为67.13％。受访高血压患者的家庭灾难性卫生支出发生率、平均差距、相对差距分别为23.03％、19.37％、84.12％。在不同收入水平下，灾难性卫生支出发生率、平均差距、相对差距在最贫困家庭组分别为72.67％、96.79％、133.18％，而在富有家庭组分别为1.94％、0.47％、24.00％。在不同医保类型中，“新农合”参保患者的灾难性卫生支出的发生率最高，达31.30％。家庭收入水平、是否存在并发症和医保类型是影响高血压患者灾难性卫生支出的主要因素（P＜0.05）。结论：不同收入水平高血压患者灾难性卫生支出发生情况不同，随着收入水平的提升，高血压患者灾难性卫生支出的发生率不断降低；但“新农合”对家庭卫生支出的保障力度较弱。建议我国对收入水平较低的家庭和慢性疾病患者给予一定程度的政策倾斜，做到应治尽治，切实保障高血压患者权益。 |
| ABSTRACT： | OBJECTIVE：To e xplore the health economic burden of hypertension patients at county-level areas and its influential factors in China. METHODS ：A questionnaire survey was conducted on hypertension patients in 7 county-level public hospitals from 6 provinces as Hebei ，Shandong，Shanxi provinces by using a convenient sampling method. Catastrophic health expenditure was defined by the standard of “medical and health expenditure exceeding 10％ of household income ”. The incidence ， average gap and relative gap of catastrophic health expenditure were analyzed. A multi-factor Logistic regression model analysis was used to analyze the influential factors that lead to catastrophi c health expenditure. RESULTS ：A total of 1 378 questionnaires were sent out ，and 925 valid questionnaires were collected with effective rate of 67.13％ . The incidence of catastrophic health expenditure，average gap and relative gap among hypertension patients were 23.03％，19.37％ and 84.12％，respectively. At different income levels ，the incidence of catastrophic health expenditure，average gap and relative gap were 72.67％ ， 96.79％ and 133.18％ in the poorest household group ，and were 1.94％ ，0.47％ and 24.23％ in the richest household group. Among different types of medical insurance ，the incidence of catastrophic health expenditure in patients covered by “New Rural Cooperative Medical Scheme （NRCMS）”the highest （31.30％）. The household income ，complications and the type of health insurance had significant impacts on the incidence of catastrophic health expenditure in hypertension patients （P＜0.05）. CONCLUSIONS：The incidence of catastrophic health expenditure in hypertension patients with different income levels is different. As the income level raised ，the incidence of catastrophic health expenditures continued to decrease. But the protection of household health expenditure by NRCMS is weak. It is suggested that a certain policy preference should be given to families with low income and patients with chronic diseases ，so as to ensure the rights and interests of patients with hypertension . |
| 期刊： | 2020年第31卷第22期 |
| 作者： | 顾佳慧，翟琛琛，韩泰森，罗震寰，保琦，管晓东，史录文 |
| AUTHORS： | GU Jiahui，ZHAI Chenchen ，HAN Taisen ，LUO Zhenhuan ，BAO Qi，GUAN Xiaodong ，SHI Luwen |
| 关键字： | 高血压；卫生经济负担；灾难性卫生支出；县级地区；影响因素 |
| KEYWORDS： | Hypertension；Health economic burden ；Catastrophic health expenditure ；County-level areas ；Influential factors |
| 阅读数： | 253 次 |
| 本月下载数： | 8 次 |
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