Economic Burden And Quality Of Life In Patients With Hepatitis B-related Diseases

Objectives To investigate the hepatitis B-related diseases patients’ economy burdenand influencing factors. To evaluate the hepatitis B-related diseases patients’quality of lifeand to explore the potential influencing factors.Methods Cluster sampling for cases collected consecutively during the study periodwas administrated. Hospitalization costs, quality of life and other related information wereinvestigated after the patients were discharged from the hospitals. The step model methodwas used for the direct economic burden, Human Capital Approach was used for the indirecteconomic burden, and willingness to pay method was used for the intangible economicburden. Multiple linear stepwise regression models were conducted to determine influencingfactors of the economic burden.Short Form36the Health survey Questionnaire was used to evaluate quality of life inpatients with hepatitis B-related diseases. Symptom Check list-90was used to evaluatemental health of patients. Multiple linear stepwise regression models were conducted todetermine influencing factors of the quality of life.Results The once direct, indirect and total costs in patients with hepatitis B-relateddiseases were￥16257.05,￥2403.96,￥18661.02respectively; The annual direct medical anddirect non-medical costs were￥26199.23,￥2086.53respectively, and the annual directeconomic, indirect economic, intangible economic and total economic burdens were￥28285.76,￥3315.63,￥56366.41,￥87967.80respectively.The main influencing factors of annual direct economic burden of patients were thelength of stay, hospital stratification, the type of hepatitis B-related diseases and complications; The main factors of indirect economic burden were the length of stay,household register ground, the type of hepatitis B-related diseases, hospital stratification aswell as complications; The main factors of intangible economic burden were householdregister ground, hospital stratification, the patient’s annual income, the type of hepatitisB-related diseases, education level and the length of stay; The main factors of total economicburden were the length of stay, the hospital stratification, the type of hepatitis B-relateddisease, the patient’s annual income, household register ground and gender.Compared with the Chinese normal model, the scores of physical Functioning, RolePhysical, bodily Pain, General Health, Vitality，Social Function, Role Emotional and MentalHealth from the SF-36scale in patients was lower than those in controls; The patients’ scoresof somatization， obsessive-compulsive symptoms, interpersonal sensitivity, depressionsymptoms, anxiety symptoms, hostility, terror, paranoia and psychotic from the SCL-90scalewere higher than those of the national norm.The main influencing factors of Physical Component Summary of patients were the age,the length of stay, the patient’s monthly income, the type of hepatitis B-related diseases,education level, gender and complications; The main factors of Mental Component Summarywere the length of stay, age, medical insurance, smoking, marital status, the type of hepatitisB-related disease and the impact of income on the patients; The main factors of the overallquality of life were the age, the length of stay, the patient’s monthly income, the type ofhepatitis B-related diseases, age, medical insurance, smoking and marital status.Conclusion Hepatitis B-related disease was not only a heavy economic burden to thepatients, but also had put mental pain and pressure on patients. The direct and indirecteconomic burden increased with the severity of the hepatitis B diseases, and the same tointangible economic burden; Different methods to estimate the indirect economic burdenhave different results, so how to select the best method is worth of exploring further;Willingness to pay method for intangible economic burden will be worth considering and using further; The main influencing factors of economic burden of hepatitis B-relateddiseases were length of stay, the hospital stratification, the type of hepatitis B-related diseasesand complications.Various dimensions of the patient’s quality of life scores show downward trend and themental health factor scores show upward trend, so the patient’s physical health and mentalhealth were significantly damaged; Scores of each dimension of quality of life and overallquality of life decreased with increasing age, meanwhile, the scores in patients withcomplications were higher than those in patients without complications. The main influencingfactors of quality of life of patients were the age, the length of stay, the type of hepatitisB-related diseases and complications.