北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (2): 226-231.

• 论著 • 上一篇    下一篇

煤工尘肺住院患者疾病负担及其影响因素分析

张磊1,2,朱磊3,李志恒3,李金洲3,潘宏伟3,张少峰3,秦文华2,何丽华1△   

  1. (1.北京大学公共卫生学院劳动卫生与环境卫生学系,北京100191; 2. 河南省职业病防治研究院,郑州450052; 3. 中国平煤神马集团职业病防治院, 河南平顶山467001)
  • 出版日期:2014-04-18 发布日期:2014-04-18

Analysis on the disease burden and its impact factors of coal worker’s pneumoconiosis inpatients

ZHANG Lei1,2,ZHU Lei3,LI Zhi-heng3,LI Jin-zhou3,PAN Hong-wei3, ZHANG Shao-feng3,QIN Wen-hua2,HE Li-hua1△   

  1. (1. Department of Occupational and Environmental Health Sciences, Peking University School of Public Health,Beijing 100191,China; 2. Research of Occupational Diseases Prevention and Control in Henan Province, Zhengzhou 450052, China; 3. Institute of Occupational Diseases Prevention and Control of China Pingmei Shenma Group, Henan Pingdingshan 467001, China)
  • Online:2014-04-18 Published:2014-04-18

摘要: 目的:调查煤工尘肺(coal worker’s pneumoconiosis,CWP)的疾病负担情况,探讨其影响因素,为制定减轻CWP疾病负担的卫生政策,最优化配置稀缺的医疗资源提供基线数据和量化分析结论。方法:选取2011年在某煤业集团职业病防治院住院的CWP患者为研究对象,调查其疾病负担。CWP住院患者的直接经济负担以住院期间总医疗费用和伙食营养补助表示,间接经济负担采用伤残调整生命年(disability adjusted life years,DALYs)结合人力资本法进行测算,并用DALYs全面衡量CWP的疾病负担,同时还分析了住院期间总医疗费用的影响因素。结果:194例CWP住院患者2011年直接经济负担467.70万元,人均24 108.05元,间接经济负担697.96万元,人均35 977.36元,因CWP损失的健康生命年为1 681.53年,人均健康生命年损失为(8.67±3.65)年。结论:CWP的医疗成本、间接成本及健康生命年损失是巨大的;产生较高医疗成本的主要影响因素是年龄和总住院天数,年龄越大,总住院天数越长,住院医疗费用越高;采取有效控制措施预防CWP发病是减少其疾病负担的关键。

关键词: 煤肺病, 患病代价, 卫生保健费用, 伤残调整生命年

Abstract: Objective: To obtain the baseline data and decision of quantitative analysis for the allocation of scarce health care resources,and for the health policymaking about easing the disease burden, to provide estimation of the economic costs and the disability-adjusted life years (DALYs) loss of the coal worker’s pneumoconiosis (CWP) and to explore the influencing factors of the disease burden. Methods: The CWP inpatients from the Institute of Occupational Diseases Prevention and Control of a Coal Mining Group for 2011 were recruited in the study. Multiple dimensions of the disease burden were measured in the inception cohort of the 194 CWP inpatients: the direct economic burden, the indirect economic burden and the DALYs loss. The direct economic burden of the inpatients included hospitalization expenses and food allowances and nutritional supplements. The indirect economic burden was estimated using the DALYs and human capital approach,and the influencing factors of hospitalization expenses were analyzed in this study. Results: The estimated direct economic burden for the 194 CWP inpatients for 2011 was approximately 4.68 million yuan and direct burden per capita was 24 108.05 yuan, and their indirect burden about 6.98 million yuan and indirect burden per capita 35 977.36 yuan. The study discovered that 1 681.53 health years were lost for the CWP inpaitents and per capita health years loss (8.67±3.65) years. Conclusion: The medical cost, the indirect cost and the DALYs loss of CWP are all sizable. Age and length of stay in the hospital are the major influencing factors for high hospitalization expenses. The hospitalization expenses of the CWP inpatients increase with their age and length of stay in the hospital. Taking effective measures to reduce the morbility is the key point to reduce the CWP burden.

Key words: Anthracosis, Cost of illness, Health care costs, Disability-adjusted life years

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