The Study Of Infectious Disease Burden In Chongqing

Object: To investigate the people of Chongqing and to understand thedirect and indirect economic burden,in order to draft the control measuresof infectious disease and reduce the economic burden of infectious diseaseof residents and provide scientific basis for health administrative to dividethe health resource.Methods:①Establish the typical symptoms of nodifiable infectiousdiseases according to the typical clinical symptoms and epidemiologicalcharacteristics. Various nodifiable infectious diseases are divided into fivecategories, namely intestinal infectious diseases, respiratory diseases, bloodand sexually transmitted diseases, natural foci and insect-borne infectiousdiseases, neonatal tetanus, based on literature reviewing and expertsconsulting, and initially screen the typical symptoms of them.②Survey oftypical symptoms of infectious diseases diagnosis of the probability ofinfectious disease and related cost: survey outpatient and inpatient cases ofthe Three Gorges Central Hospital and People Hospital of Shapingba fromjuly2012to june2013use retrospective methods. The typical symptoms ofinfectious diseases diagnostic probability and related cost adopt SAS9.2software to statistics analysis.③The situation of individual with typicalsymptoms of infectious diseases and relative cost: Randomly selected40districts and counties in Chongqing,totally24communities and48villageswere selected from6districts. Household survey questionnaire theindividuals who have typical symptom of infectious disease and the relativecosts. Result:①Typical symptom of infectious disease: Delphi method wasused to determine the typical symptoms of five notifiable infectiousdiseases in primary screen. Two rounds of experts reviewed the results:the questionnaire recovery rate was100%; expert judgment coefficient was0.841; expert authority coefficient was0.851; the academic level of expertweight value was0.863; experts familiar with the coefficient was0.850; thecoordination coefficient of two rounds experts was0.256and0.310(P<0.05). Determine the typical symptoms of infectious diseases ofthe population questionnaire and the hospital questionnaire based on: fever,diarrhea(above3times/day),cough, tetter, bloody purulent stool, stickysecretion of genitals or urethra, eczema, itching, erosion, ulcer, pain, suckhard, tic and spasm.②Typical symptoms of infectious diseases diagnostic probability andrelated cost. In hospital survey, total93495hospitalized cases and787079outpatient cases in two hospitals;65043cases with typical symptoms inhospitalized and191541cases with typical symptoms in outpatient,6255cases with notifiable disease in hospitalized and22090with notifiabledisease cases in outpatient. The interval of the probability of the case whohave typical sympotoms diagnosis infectious was0.0415to0.0439, Surveyin the database of hospital, there are11projects fee in outpatient of hospitalwith infectious disease, inspection fee of outpatient (91.92RMB percapita), examine fee of outpatient (44.55RMB per capita), anesthesia fee(0.14RMB per capita), eisai fee (0.04RMB per capita), medicinefee(118.64RMB per capita), beds fee(0.03RMB per capita);radiation fee(17.29RMB per capita), diagnosis and treatment fee of outpatient (5.34RMB per capita), treatment fee of outpatient (19.24RMB per capita),herbal fee (0.29RMB per capita), patent fee (32.21), registered fee ofoutpatient (2.32RMB per capita) and drug fee of outpatient (127.21RMB per capita). There are14projects fee in hospitalization with infectiousdisease, herbal fee (19.78RMB per capita), nursing fee (87.79RMB percapita), inspection fee (1341.97RMB per capita), examine fee (981.32RMB per capita), other fee (519.09RMB per capita), surgery fee (326.30RMB per capita), eisai fee (58.09RMB per capita), medicine fee (4780.46RMB per capita), nutrition fee (9.35RMB per capita), blood fee (150.05RMB per capita), treatment fee (2089.25RMB per capita), patent medicinefee (1041.85RMB per capita), bed fee of hospitalization (2.39RMB percapita), medicine fee of hospitalization (20.69RMB per capita).③Survey on typical symptoms of people and relative cost. Total10608cases include48administrative and24community from6areas. Inthe crowd，there were5412cases had typical symptoms. In the crowd,therespondents who have typical symptoms cost713623.5RMB in total, theper capita cost as blow: cost of transportation with treatment (88.60RMB),cost of nutrition with treatment (220.67RMB), cost of favour withtreatment (158.21RMB), cost of gift with treatment (290.62RMB), time ofsick with treatment (8.04days), time of delay with treatment (9.02days),time of delay of relatives and friends with treatment (8.85days), cost oftransportation with no treatment (119.28RMB), cost of gift with notreatment (156.58RMB) time of sick with no treatment (5.85days), time ofdelay with no treatment (7.34days), time of delay of relatives and friendswith no treatment (9.89days), the per family cost as blow: cost oftransportation with treatment (149.03RMB), cost of nutrition withtreatment (347.24RMB), cost of favour with treatment (213.30RMB), costof gift with treatment (389.83RMB), Under treatment, the per capita ofindirect cost was401.92RMB of people who have infectious disease ofChongqing and the average direct cost of family was703.86RMB, the costof delay of per capita with treatment was450.91RMB and the average indirect cost of family was771.85RMB, the cost of delay of relative andfriend with treatment wad442.41RMB and the average indirect cost offamily was757.35RMB. Under no treatment, the per capita of indirect costwas294.44RMB of people who have infectious disease of Chongqing andthe average direct cost of family was484.40RMB, the cost of delay of percapita with no treatment was366.93RMB and the average indirect cost offamily was655.36RMB, the cost of delay of relative and friend with notreatment was494.40RMB and the average indirect cost of family was990.30RMB.Conclusions:①The interval of infectious disease incidence ofpopulation in Chongqing was0.02233to0.02360and it was higher thanmonitoring of Chongqing.②In Chongqing,the per capita of hospital costwas11428.38RMB of infectious disease， the per capita of outpatient costwas464.37RMB. The direct cost of per capita was758.1RMB, theindirect cost of per capita was1295.24RMB, the direct cost of per family1099.4RMB, indirect was2233.06RMB. The situation of no doctorexamine, the direct cost of per capita was275.86RMB, the indirect cost ofper capita was1155.77RMB, the direct cost of per family402.99RMB,indirect was2130.07RMB.