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背景:结核病的诊断需要多次就诊。减少诊断过程中的就诊次数,可使服务更具可及性,并大大节约患者的费用。目的:描述患者在肺结核诊断中心就诊时发生的直接费用。方法:在也门和尼泊尔,使用设计好的问卷,对咳嗽时间超过3周的成年人进行面对面调查,并记录他们的费用。结果:共调查了456例成年人。大多数患者就诊时都有人陪同,其中20%是涂阳患者。在尼泊尔,患者男性比例、居住在城市地区比例和平均年龄均高于也门(尼泊尔:123/206[60%],152[74%],平均年龄41岁;也门:120/250[48%],114[36%],平均年龄35岁)。虽然农村地区的患者多数住在亲戚家,但他们的整体费用仍高于城市地区的患者。在2个国家,最高的费用支出均为诊疗费,而且农村患者支付的诊疗费高于城市患者。诊断的费用相当于1周的人均国民收入。结论:患者需要承担相当大的诊断费用,而在医疗机构的诊疗费是这些费用的主要部分。需要接受结核病检查的患者应该能够得到免费的诊断服务。
Background: The diagnosis of tuberculosis requires multiple visits. Reducing the number of visits during the diagnosis can make the service more accessible and significantly save the patient’s costs. Purpose: Describe the direct costs of a patient who visits a diagnostic center for tuberculosis. Methods: In Yemen and Nepal, face-to-face surveys of adults who cough longer than three weeks were recorded using well-designed questionnaires and their costs recorded. Results: A total of 456 adults were investigated. Most patients are accompanied by visits, of which 20% are smear-positive patients. In Nepal, the proportion of male patients, the proportion of people living in urban areas and the average age are higher than those in Yemen (Nepal: 123/206 [60%], 152 [74%], mean age 41 years; Yemen: 120/250 [48%]) , 114 [36%], mean age 35 years). Although the majority of patients living in rural areas live with relatives, their overall costs are still higher than those in urban areas. In both countries, the highest cost is medical treatment, and rural patients pay more for their treatment than urban patients. The cost of diagnosis is equivalent to one week’s national income per capita. Conclusion: Patients need considerable diagnostic costs, and medical fees at medical institutions are a significant part of these costs. Patients who need to undergo tuberculosis screening should be able to get free diagnostic services.