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目的了解无锡市老年高血压、糖尿病患者的疾病直接经济负担,为有效控制老年慢性病患者医疗费用、制定社区慢性病管理策略提供科学依据。方法对随机抽取的439例社区老年高血压和(或)糖尿病患者开展问卷调查,根据调查所得的卫生服务利用情况以及药品、门诊和住院费用计算社区老年高血压和(或)糖尿病患者疾病直接经济负担。结果被调查的无锡市社区老年高血压和(或)糖尿病患者药物治疗依从性为92.7%,调查前3个月门诊就诊率为71.30%,人均就诊次数为5.07次,调查前1年住院率为12.53%,人均住院次数为0.17次。年人均药品总费用为2 494.57元,次均门诊费用为127.19元,次均住院费用为13 469.00元,无锡市老年高血压和(或)糖尿病患者年人均疾病直接经济负担为7 518.79元,全市老年高血压和(或)糖尿病患者年疾病直接经济负担约49.77亿元。结论无锡市老年高血压、糖尿病疾病直接经济负担沉重,应当加强社区老年慢性病管理,制定相关防制政策和补偿制度,以有效控制病程,降低疾病经济负担。
Objective To understand the direct economic burden of diseases of elderly people with hypertension and diabetes mellitus in Wuxi City and provide scientific evidences for the effective control of elderly patients with chronic diseases and the development of community chronic disease management strategies. Methods A questionnaire survey was conducted on 439 elderly patients with hypertension and / or diabetes randomly selected from the community. Based on the surveyed utilization of health services and the cost of medicine, outpatient and inpatient services, the direct economy of elderly patients with hypertension and / or diabetes was calculated burden. Results The compliance rate of drug treatment in elderly patients with hypertension and / or diabetes was 92.7% in the surveyed community in Wuxi. The outpatient visit rate was 71.30% in the first three months of the survey and the average number of visits was 5.07. The hospitalization rate in the first year before the survey was 12.53%, the number of hospitalizations per capita was 0.17 times. The per capita cost of medicine per capita was 2 494.57 yuan, the average outpatient expense was 127.19 yuan and the average hospitalization cost was 13 469.00 yuan. The direct economic burden of per capita illness of elderly people with hypertension and / or diabetes in Wuxi was 7 518.79 yuan, The annual economic burden of elderly people with hypertension and / or diabetes is about 4.977 billion yuan. Conclusion The direct economic burden of elderly hypertension and diabetes mellitus in Wuxi City is heavy. Management of elderly chronic diseases in community should be strengthened and relevant prevention and control policies and compensation systems should be formulated to effectively control the disease course and reduce the economic burden of diseases.