| Objective:Knowing the diarrhea morbidity and prevalent features of the people in Gansu Province, knowing the consultation rate and consultation behavior features of the patients who suffer the diarrhea disease, investigating into the treatment of diarrhea patients direct medical costs, direct non-medical costs and indirect costs and economic burden, collecting the experience and data for correctly evaluating the hazardous degree of diarrhea diseases and its place in the disease control and prevention.Methods:1. On the basis of the crowd, I take the lamination multi-stage stochastic group sampling method. It was divided into 2 levels: urban and countryside. According to the region's GDP, the PPS method is used to draw two cities (Lanzhou City and Wuwei City), each of the city draws one municipal district by simple random sampling method (Lanzhou Chengguan District and Wuwei Liangzhou District) and one county (Lanzhou Yuzhong County and Wuwei Gulang County). Each municipal district draws two streets by means of system sampling method and each street draw by system sampling method. Each county draws 3 villages and towns by system sampling method, each village and town draws 2 administrative villages by system sampling method. Altogether 8 community residents' committees and12 administrative villages are drawn. It carries out four residence investigations each year to know the level of crowd diarrhea morbidity, the reason of diarrhea, the consultation situation and the disease burden.2. To analyze descriptively the index such as diarrhea two weeks morbidity, consultation rate, the direct medical costs, direct and indirect costs of non-medical, to extrapolate the related index by weighted sampling and weighted demographic adjustment.Result: In this investigation, totally 549 people in the investigated 41265 people have the diarrhea. 286 people suffer the diarrhea within two weeks. The two-week morbidity is 0.69%. 437 people suffer the diarrhea within one month. The one-month morbidity is 1.06%. 587 people suffer the diarrhea within three months. The three-month morbidity is 1.42%. By using the two-week morbidity, we can extrapolate that the annual morbidity is 0.69%.The two-week morbidity of the urban population is 0.56%. The two-week morbidity of the rural population is 0.82%. The two-week morbidity of the rural population is higher than the two-week morbidity of the urban population. The two-week morbidity of the male is 0.78% and the two-week morbidity of the female is 0.61%. The two-week morbidity of the male is higher than the two-week morbidity of the female. From the point of onset age, there are significant differences between the different age groups: 2.3% between 0 and 4 years old, 1.24% between 60 and 64 years old, 41.04% between 45 and 50 years old, and 0.98% above 75 years old which are all above the average level. The two-week morbidity of different occupations is significant, with children scattered 2.45%, preschools children 1.08%, housewives 1.07%, service personnel in public places 0.84%, farmers 0.8% which are all above the average level of morbidity. The two-week morbidity of different literate level is significant of which preschool children 1.97%, illiterate or semi-literate 1.20 %, primary schools 0.78%, which are all above the average level of morbidity.Through analyzing the two-week diarrhea cases we find that 2-3 days is the most popular, accounting for 51.05 percent. Among which 4-5 times diarrhea per day accounts for 43.71%, 3 times diarrhea per day accounts for 43.01%. Diarrhea with fever cases accounted for only 10.14 percent. 98.95% of the patients with diarrhea have no complications. There are many reasons for the diarrhea occurred, the main food source accounted for 59.79 percent. When diarrhea occurs, 61.19% of the patients choose medication, 27.97% choose two or more treatments, and only 0.70% of them choose oral liquid. There are significant differences of treatment between urban and rural areas.Within two weeks, 53.15% of diarrhea patients has treatment in clinic, 3.15% of patients are hospitalized, and 43.71 percent receive no medical care. Urban and rural areas have significant differences in treatment methods. 28.57 percent of patients make an intraday visit to the doctor, and 52.17 percent go to the clinic the next day. The intervals of treatment time in urban and rural areas are significantly different.After onset of the diarrhea, 16.94 percent of patients get treatment in the street health center / community health service center, 10.93 percent go to the township health center, while 46.99 percent go to the village clinic. Most diarrhea patients are treated in the hospital below second-level. Treatment in the same level of urban and rural medical institutions has distinct difference. After onset, 60.32 percent get therapy because of light symptoms, and 62.7 percent attend themselves. In the self-attendance case, 55.56 percent buy the medicine in the pharmacy on their own.Through the calculated number we get that the personal direct medical cost of the out-patient is 68.4 Yuan; the direct medical cost of the hospitalized is 680 Yuan; the direct medical cost of the person of not seeing a doctor is 22.22 Yuan. The direct non-medical cost of the out-patient is 18.49 Yuan; the direct non-medical cost of the hospitalized is 197.67Yuan; the direct non-medical cost of the person of not seeing a doctor is 11.51 Yuan. The average loss of working time is 3.05 days for each out-patient. The average loss of working time is 11.89 days for each hospitalized. The average loss of working time is 0.86 days for those of not seeing a doctor.The direct medical cost of diarrhea patients in Gansu Province reaches 0.73 hundren million Yuan in which the direct non-medical expenses is 0.41 hundren million Yuan and the indirect costs is 0.03 hundren million.The totle Economic Burden is 1.17 hundren million.Conclusion:The high incidence of diarrhea in Gansu Province, resulting in rather heavy financial burden, particularly in children under 5 years old and the rural population, in order to control the diarrhea effectively, lower incidence of diarrhea and reduce diarrhea economy burden, health intervention measures must be taken to the two groups of people.
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