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目的了解职业病住院患者的疾病负担情况,探讨疾病负担的影响因素,为制定减轻疾病负担的卫生政策提供相应理论依据。方法 2016年3月采用整群抽样方法,选取山东省4家医院职业病科255例住院职业病患者为研究对象,进行一般情况(包括伤残等级)问卷搜集,调查疾病负担。结果住院患者直接经济负担平均每人每年(88 562±61 760)元。伤残调整生命年(DALY)(12.95±8.08)人年。社会平均间接经济损失为(367 586±229 618)元。Ⅱ、Ⅲ期尘肺患者直接经济负担高于Ⅰ期患者(P<0.01)。高伤残等级职业病患者直接经济负担高于低伤残等级患者(P<0.01)。有合并症患者流行病学负担高于无合并症患者(P<0.01)。职业病患者的直接经济负担的主要影响因素为住院天数、陪护人员的情况、营养费、疾病程度(尘肺分期及中毒分度)(P<0.01)。职业病患者流行病学负担的影响因素主要为年龄、肺功能、陪护人员情况(P<0.01、<0.05)。结论职业病患者疾病负担随着经济水平的发展有增加趋势。减轻职业病患者疾病负担,重点在调整职业病患者的住院管理制度,加强规范化治疗。
Objective To understand the burden of disease in hospitalized patients with occupational diseases and to explore the influencing factors of the burden of disease and to provide the corresponding theoretical basis for the development of health policies to reduce the burden of disease. Methods In March 2016, a cluster sampling method was used to select 255 cases of occupational diseases in occupational diseases of 4 hospitals in Shandong Province. The general conditions (including disability level) questionnaires were collected to investigate the burden of disease. Results The direct economic burden of hospitalized patients was RMB 88 562 ± 61 760 yuan per person per year. Disability adjusted life years (DALY) (12.95 ± 8.08) years. The average social indirect economic loss was (367 586 ± 229 618) yuan. Patients with stage II and stage III pneumoconiosis had a higher direct financial burden than stage I patients (P <0.01). Patients with high disability occupational diseases had a higher direct financial burden than those with low disability (P <0.01). Patients with comorbidity had a higher epidemiological burden than those without complications (P <0.01). The direct economic burden of occupational diseases are mainly related to the days of hospitalization, the accompanyants, the cost of nutrition, the degree of disease (pneumoconiosis stage and poisoning degree) (P <0.01). The main influencing factors of epidemiological burden of occupational diseases were age, pulmonary function and accompanying staff (P <0.01, <0.05). Conclusion The disease burden of occupational diseases increases with the development of economy. Reduce the disease burden of occupational diseases, focusing on the adjustment of occupational diseases in hospital management system, to strengthen the standardization of treatment.