Community Care And Economic Burden Of Disease In Patients With Chronic Filariasis Survey

Objective：To understand Zhenze town chronic filariasis patients after the elimination offilariasis with prevalence, prognosis, outcome of care, and the economic burden ofdisease, so as to provide scientific basis for the improvement of care work in patientswith chronic filariasis.Methods：The resident Zhenze town Wujiang District Suzhou city for more than50years ofage as the research object, using current status study method to investigate the status ofpatients with chronic filariasis, combined with the matched case-control study methodof economic burden of disease influence factors on patients with chronic filariasis andnon chronic filarial patients. With unified design questionnaire, face to face inquiry andfill in the questionnaire by the town hospital paramedics with a uniform training, toinvestigate the general situation of chronic filariasis patients (gender, age, residence,the local cumulative residence time, culture degree, occupation, medical security,health status, etc.)， the follow-up situation (elephantiasis degree swollen legs，Lymphatic vessels and lymph node inflammation episodes frequency per year, Courseof disease，Easy to get season，Predisposing factors，treatment and care, etc.),Economic conditions (personal annual income, family annual net income, revenuesharing population, living area, total population, whether or low income households),Medical costs (self treatment medical costs, visiting medical costs, indirect medicalcosts). The original data were checked using Epidata3.0software double dual entry,entry materials after the logic to correct after verification unified into the SPSS18.0database, using SPSS18.0software for statistical analysis.Measurement data withmean()±standard deviation(S).Count data with constituent ratio or rate.Comparison between groups using chi-square test or t-test for statistical inference.Results:1，After elimination of filariasis in Zhenze town in1998, no new patients with chronicfilariasis; When the original764cases of chronic filariasis patients,117cases ofsurviving to2013, respectively, compared with basically eliminated filariasis and the2002censuses natural reduction of84.68%,44.81%, the regional distribution has beensignificantly reduced; the legacy of the patients mostly the elderly age70to79,accounted for58.12%; patients with duration of more than50to59years,accountedfor54.70%; the site and stage of swollen lymph to the right lower limb and the Ⅱ~IIIperiod, which accounted for40.17%,46.16%of the total cases.2，Through the community, family/self care, the existing117cases of patients withchronic filariasis patients with lymphedema staging high gradually reduced, increasedstaging patients with low, compared with the previous care, the difference wasstatistically significant (P <0.05), described condition improved, and the occurrence ofpatients with lower limb lymphangitis/lymphadenitis, acute grand mal, petit mal andlower limb ulcers improved significantly (P <0.05).3，Personal annual income of chronic filariasis patients Zhenze town, the family netincome, revenue sharing population, living area, the population living together,whether low income households, such as6economic situations are similar withnon-diseased group, the difference between the two groups was not statisticallysignificant (P＞0.05).4，Health care costs in patients with chronic filariasis, in addition to the costs ofaccompanied by family members and the expenses of patients missed work,self-medication, the direct medical care (outpatient expenses, hospital expenses),indirect medical (transportation, lodging) were more than not suffering from filariasisgroup, the difference between the two groups in overall medical costs was statisticallysignificant (P <0.001). The self payment ratio of self-medication, the direct medicalcare (outpatient expenses, hospital costs) pays, which the prevalence group werehigher than non-diseased group, the difference was statistically significant (P <0.001). Conclusions:1， After elimination of filariasis in Zhenze Town, patients with chronic filariasiswassignificantly reduced, manifests the characteristics of aging, long disease course.2， Recommended by the WHO, as community, family/self care measures, canimprove the condition of patients with chronic filariasis, prevent progression of thedisease, care effect is certainly, recommended in grass-roots community promotion.3，The economic income of patients with chronic filariasis and no chronic filariasisgroup similar in Zhenze town.4，Zhenze town the medical costs of patients with chronic filariasis (exceptaccompanied by family members costs and patient delay costs) were higher than thepeople not suffering from filariasis, self paid ratio were significantly higher than thepeople not suffering from filariasis. Suggested that the government departments to givethis part of the crowd of special medical assistance or raise the proportion of costsreimbursed.