糖尿病治疗指标的意愿支付调查及影响因素分析
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篇名: 糖尿病治疗指标的意愿支付调查及影响因素分析
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摘要: 目的:为了解糖尿病患者的疾病负担及促进合理用药提供参考。 方法:采用面对面的开放式问卷,对四川省人民医院部分糖尿病患者进行意愿支付调查,采集糖尿病患者个人基本信息、健康状况、疾病经济承担能力和意愿支付等方面的数据,经整理后通过Excel(2013版)软件采用双人双录的方法编录成表,再借助SPSS 17.0软件运用逐步回归的多重线性回归方法进行统计学分析,探讨意愿支付值(WTP值)的影响因素。 结果:共发放问卷120 份,回收有效问卷106 份,有效回收率为88.3%。受访者的平均年龄为(59.9±13.9)岁,平均体质量指数(BMI)为(24.5±0.5)kg/m2,以往每月糖尿病费用≤300元的占比最高,其次是>300~500元和>500~1 000元;对空腹血糖(FPG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(HbA1c)的知晓率依次为95.3%、86.8%和68.9%;患两种以上合并症的占29.5%。受访者对3个血糖控制指标HbA1c、FPG、2 h PG完全恢复正常的WTP值均值分别为1 604.1、1 617.9、1 683.7元/月,中位数皆为1 000元/月,对3种指标恢复10%时的WTP值均值分别为867.4、908.5、877.9元/月,中位数分别为500、575、510元/月。多重线性回归模型分析中对WTP值影响为正且有统计学意义的影响因素为每年家庭总收入、合并症、住院经历、家族糖尿病史、糖尿病心理状态和以往每月糖尿病费用;对WTP值影响为负且有统计学意义的因素为年龄、FPG值和文化程度。结论:完全恢复状态的模型中,有糖尿病足、外周神经病变、高血脂等合并症的患者会有更高的WTP值。这反映合并症对糖尿病患者的疾病经济负担和精神负担较重。10%恢复状态的模型更接近实际的治疗状态,更能反映实际中对患者WTP值的影响因素,相关模型中有家族糖尿病史、心态较抑郁、以往每月糖尿病费用更高、有住院经历的患者WTP值更高。
ABSTRACT: OBJECTIVE: To provide reference for investigating the disease burden of diabetic patients and promoting rational drug use. METHODS: Open-ended questionnaires were adopted to survey the willingness to pay (WTP) of some diabetic patients in Sichuan Provincial People’s Hospital and collect the data about personal information, health status, the affordability of disease and WTP, the data was sorted with Excel (version 2013) software by two operators and analyzed with SPSS 17.0 software by step-wise multiple linear regression to explore the influential factors of WTP values. RESULTS: Totally 120 questionnaires were sent out and 106 were effectively received with effective rate of 88.3%. The average age of respondents was (59.9±13.9) years old, the average body mass index (BMI) of respondents was (24.5±0.5) kg/m2, the highest proportion of monthly diabetes fees was no more than 300 yuan, followed by more than 300-500 yuan and more than 500-1 000 yuan; the awareness rates of fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 h PG) and glycated hemoglobin (HbA1c) were 95.3%, 86.8% and 68.9%, respectively; and patients with more than 2 complications accounted for 29.5%. The WTP values of respondents to the complete recovery of HbA1c, FPG and 2 h PG were 1 604.1, 1 617.9 and 1 683.7 yuan/month, the median values were 1 000 yuan/month; the WTP values of respondents to the 10% recovery were 867.4, 908.5 and 877.9 yuan/month, the median values were 500, 575 and 510 yuan/month, respectively. The influential factors with positive effects and significant differences on WTP values in step-wise multiple linear regression were total annual household income, complications, hospital experience, family history of diabetes, diabetes mental status and cost of diabetes in the past months; those with negative effects and significant differences on WTP values were age, FPG level and education level. CONCLUSIONS: Diabetic patients, particularly, with peripheral neuropathy, high blood lipids or diabetic foot have higher WTP value, which shows they hole heavier mental burden and disease burden than others. Patients recovered 10% percent were closer to actual treatment state, which better show the influential factors of WTP values actually, and patients with a family history of diabetes, depressed mood, higher fees in the average monthly cost, and hospital patients have higher WTP values.
期刊: 2016年第27卷第18期
作者: 陈洁,龙恩武,胡明
AUTHORS: CHEN Jie,LONG Enwu,HU Ming
关键字: 糖尿病;意愿支付值;影响因素;多重线性回归;完全恢复状态;10%恢复状态
KEYWORDS: Diabetes; Willingness to pay; Influential factors; Multiple linear regression; Complete recovery; 10% recovery
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