The Study Of Economic Burden And Influencing Factor On Hemodialysis And Peritoneal Dialysis For ESRD Patients

ObjectiveThe therapeutic effect analysis of this research base on the social economy,population sociology,primary cause,medical security,dialysis costs,hospital costs,transportation costs,nutritional costs etc.,measure the direct and indirectly economic burden of the disease,which surveyed on 6008 end-stage renal disease hemodialysis patients in 41 hospitals,in Henan,Hunan,Hubei,Liaoning,Zhejiang and Jiangsu province.To understand the current hemodialysis and peritoneal dialysis patients due to the treatment of end-stage renal disease need to bear the impact of economic pressure factors,with a view to the use of scientific and appropriate dialysis methods to rationally reduce the cost of dialysis treatment,to minimize the economic burden,to avoid " Due to disease caused by poverty,due to illness to the poor " to improve the quality of life of patients with end-stage renal disease,improve quality of lifeand social return rate of the end-stage renal disease patients and provide realistic basis for health decision of hospitals,patients,health administration department and medical insurance institutions.MethodsUsing the method of on-site questionnaire survey,questionnaire survey and interview method were used to retrospectively investigate hemodialysis and peritoneal dialysis patients,and the questionnaire survey and access to medical records were used.The contents of the survey include: the characteristics of population sociology(patient sex,age,marital status,educational level,etc.),economic burden(dialysis costs,kidney disease drug costs,laboratory fees,hospital costs,self-paid costs,health insurance reimbursement costs,etc.)Quality evaluation index(dialysis treatment effect,recovery of labor capacity,patient satisfaction,etc.).In this study,Epidata 3.1 was used to establish the database,and the data were double-recorded.SPSS 21.0 was used for statistical analysis.Results(1)Contrasting and analyzing the age,there was statistical significance(P<0.001).The age of hemodialysis patients is concentrated in 50 to 69 years old and it's at 46.2%.The count of patients is increased with the increase of age and begin decreasing after the age of 70 years old.The age of hemodialysis patients is concentrated in 40 to 59 years old and it's at 51.2%.(2)Contrasting and analyzing the primary cause,there was no statistical significance(P=0.375).The top there primary cause are chronic glomerulonephritis(39.6%),diabetic nephropathy(16.4%),hypertensive nephropathy(14.2%).(3)Contrasting and analyzing the medical insurance,there was statistical significance(P <0.001).Hemodialysis patients to participate in the basic medical insurance accounted for 93.83%,peritoneal dialysis patients to participate in the basic medical insurance accounted for 98.88%,which participate in urban workers basic medical insurance hemodialysis patients more than peritoneal patients,to participate in new rural cooperative medical care of hemodialysis patients less than peritoneal dialysis patients.(4)Contrasting and analyzing the disease economic burden,there was statistical significance(P <0.001).Direct disease economic burden hemodialysis percapita 102000 yuan,peritoneal dialysis percapita 72400 yuan;indirect disease economic burden hemodialysis was 649627 yuan,peritoneal dialysis patients 634167 yuan.Hemodialysis were higher than peritoneal dialysis.(5)Contrasting and analyzing the family economic burden,there was statistical significance(P <0.001).Hemodialysis in the cost of self-paid,health insurance reimbursement costs,borrowing costs,social assistance costs and other aspects of the mean higher than the peritoneal dialysis.(6)Contrasting and analyzing the in different regions and different levels of hospital dialysis,the direct economic burden of Henan Province,Hubei Province,Hunan Province is higher than that of Zhejiang Province,Jiangsu Province and Liaoning Province.From the dialysis method,the direct economic burden of hemodialysis Through,and the gap is obvious.Tertiary hospital hemodialysis cost of 108022 yuan,71929 yuan peritoneal dialysis patients,hemodialysis and peritoneal cost ratio of about 1: 1.5.Conclusions(1)The direct economic burden and indirect economic burden of end-stage renal disease in peritoneal dialysis patients were lower than those in hemodialysis patients.The main influencing factors of hemodialysis were the educational level,occupational type and hospital level.The main influencing factors of peritoneal dialysis economic burden included: education level,type of medical insurance,the cause of the disease and the level of medical treatment hospital.(2)The economic burden of hemodialysis disease Zhejiang Province,Jiangsu Province,the proportion of medical insurance reimbursement is higher than Henan Province,Hubei Province,Hunan Province and Liaoning Province.The proportion of paid less than Henan Province,Hubei Province,Hunan Province and Liaoning Province.Peritoneal dialysis disease economic burden Zhejiang Province,Hunan Province,Medicare reimbursement ratio is higher than other provinces,Zhejiang Province,Henan Province,the proportion of paid less than other provinces.The proportion of medical insurance reimbursement and self-payment influenced by the level of economic development.(3)With the accelerated process of aging in our country,the incidence of end-stage renal disease in the elderly population,the population trends to younger,in order to effectively reduce the dialysis patients,health insurance departments and the whole society of economic burden,China's national conditions to promote peritoneal more practical significance and more health economics significance.