Analysis Of The Economic Burden And Influencing Factors Of Hepatitis B Related Diseases In Taizhou City Of Zhejiang Province

ObjectiveTo understand the economic burden of patients with hepatitis B related diseases in Taizhou of Zhejiang province,and to provide the relevant parameters for the health economic evaluation of hepatitis B vaccination and other prevention and control strategies,so as to provide the data for the prevention and control of hepatitis B.MethodsA cluster sampling method for continuous cases in the time period was used to investigate the eligible hepatitis B cases,with the questionnaires mainly addressed the general statues of patients,the number of outpatient service and hospitalization in the past one year,the medical expenses,transportation costs and the working time delays during the treatment.The expenses of hospitalization for hospitalized cases were collected through Electronic Medical Record System.The economic burden includes direct and indirect costs,and the direct costs were divided into direct medical expense and direct non-medical expense.A stepwise model was used to make summarization.The annual per capita economic burden for outpatient equals to per capita direct and indirect cost per outpatient visit multiply by times of annual per capita outpatient.The annual per capita economic burden for hospitalization equals to per capita direct and indirect cost per hospitalization multiply by times of annual per capita hospitalization.The annual per capita economic burden of patients with hepatitis B related diseases was added up by annual per capita outpatient economic burden and annual per capita hospitalization economic burden.The human capital method was applied to measure the intangible.Mean,median,frequency,percentage and four percentile were applied for statistical description.The nonparametric test was used to analyze the general distribution difference on the times of outpatients and hospitalization,and the factors influencing the hospitalization cost were analyzed by multiple linear regression.Results1.The annual per capita economic burden of patients with hepatitis B related diseases was 34600.40 yuan,among which,the proportion of economic burden of the hospitalization to the outpatients was about 3:1.The per-time hospitalization expenses of the patients with hepatitis B related diseases were 14357.16 yuan,of which 4/5 were direct medical expenses.The per-time out-patient expenses were 849.34 yuan,of which 3/4 were direct medical expenses.The average outpatient cost of direct non-medical was 46.45 yuan,while the indirect cost was 178.36 yuan.The average hospitalization cost of direct non-medical is 1077.39 yuan,while the indirect cost is 1718.83 yuan.The proportion of self-payment of outpatient and inpatient were 60.48%and 49.66%respectively.The drug cost the most during hospitalization,which accounted for 45.41%.2.Among four kinds of HBV related diseases that contained chronic hepatitis,compensatory cirrhosis,decompensated cirrhosis and primary liver cancer,the highest annual per capita economic burden is 51291.47 yuan for patients with decompensated cirrhosis,and the lowest annual per capita economic burden is 22800.52 yuan for chronic hepatitis patients.3.Single factor analysis showed that age,medical insurance type,the influence of illness on income,antiviral treatment and disease type were the factors that with statistical significance.Multiple linear regression showed that the number of hospitalization days,type of disease and the proportion of drug expense were the factors that with statistical significance.4.The coefficient of variation of intangible cost is large,and the average intangible cost exceeds the annual per capita economic burden.Conclusions1.The direct medical cost is the main economic burden of hepatitis B related diseases,and the direct non-medical cost is lower than the indirect cost.The proportion of self-payment in hepatitis B is high.The drugs expeinses account a lot.2.Age,type of medical insurance,the influence of illness on income,antiviral treatment and type of disease were the factors affecting the number of outpatients or the number of hospitalization,the time of hospitalization,the type of disease and the ratio of medicine were the factors affecting the cost of direct hospitalization.3.The economic burden of hepatitis B related diseases is heavy,and the burden increases with the aggravation of illness.