ABSTRACT
Objective Less surveys on the economic burden of hepatitis B (HB)-related diseases have been conducted in China,so the socioeconomic harm caused by the diseases is not clear and the key parameters for economic evaluation of hepatitis B prevention and treatment are lacking.This study aimed to analyze the direct,indirect and intangible expenditures of hospitalized patients with HB-related diseases during hospitalization and during a year in different areas of China.Methods The hospitals for infectious diseases and the large general hospitals in 12 areas in China were selected in the study.All the inpatients with HB-related diseases were surveyed by cluster sampling of consecutive cases.The direct expenditure included direct medical cost and direct non-medical cost.The indirect expenditure,including work loss of patients and caregivers,were calculated by using human capital method for urban and rural populations in 12 areas.The intangible expenditure were reflected by willing to pay and stochastic tournament.The influencing factors of direct and indirect costs were identified by stepwise linear multi-variation regression analysis.Results A total of 27 hospitals in 12 areas were included in the survey.A total of 4 718 cases were surveyed,the overall response rate was 77.7％.The average hospital stay was 29.2 days (27-34) and the hospitalization expenditure was averagely 16 832.80 yuan (RMB) per case,in which the highest proportion (61.2％)was medicine fees [10 365.10 yuan (RMB)].The average direct expenditure and indirect expenditure were consistent with the severity of illness,which were 18 336.10 yuan (RMB) and 4 759.60 yuan (RMB) respectively,with the ratio of 3.85:1.The direct medical expenditure [17 434.70 yuan (RMB)] were substantially higher than the direct non-medical expenditure [901.40 yuan (RMB)].It was found that the hospitalization expenses was highest in direct medical expenditure and the transportation expenses was highest in direct non-medical expenditures.Among the average indirect expenditure,the loss of income for the patients [3 832.50 yuan (RMB)] was higher than that for the caregivers [927.20 yuan (RMB)],The total direct and indirect expenditure was highest for liver transplantation,followed by severe hepatitis,hepatocellular carcinoma and decompensated cirrhosis,acute hepatitis B,compensated cirrhosis and chronic hepatitis B.The influencing factors for both direct and indirect expenditure were high hospital level,severity of hepatitis B,living in urban area,antiviral therapy,long hospitalization and monthly income of family.For average 3.74 outpatient visits and 1.51 hospitalization,the average annual direct,indirect and intangible expenditure for HB-related diseases were 30 135.30,6 253.80 and 44 729.90 yuan (RMB) [totally 81 119.00 yuan (RMB)],accounting for 37.3％,7.7％ and 55.0％,respectively.Of the annual direct medical expenditure [28 402.80 yuan (RMB)],which were much higher than non-medical expenditure [1 732.50 yuan (RMB)],hospitalization expenditure [26 074.20 yuan (RMB)] was higher than outpatient visit expenditure [4 061.10 yuan (RMB)].The annual indirect expenditures for outpatient visit and hospitalization were 763.60 and 5 490.10 yuan (RMB),respectively.Of the annual intangible expenditure,the highest was that for/primary hepatocellular carcinoma,followed by cirrhosis,chronic hepatitis B,severe hepatitis B,liver transplantation and acute hepatitis B.Conclusions A heavy economic burden has been caused by HB-related diseases in China,and patients are more likely to rely on medical service rather than non-medical service.It is necessary to take effective treatment measures to prevent the adverse outcome of HB related diseases and achieve significant economic benefits.The influence of HB related diseases on mental health of the people can be reflected by an economics term,intangible expenditure.
ABSTRACT
Objective Less surveys on the economic burden of hepatitis B (HB)-related diseases have been conducted in China,so the socioeconomic harm caused by the diseases is not clear and the key parameters for economic evaluation of hepatitis B prevention and treatment are lacking.This study aimed to analyze the direct,indirect and intangible expenditures of hospitalized patients with HB-related diseases during hospitalization and during a year in different areas of China.Methods The hospitals for infectious diseases and the large general hospitals in 12 areas in China were selected in the study.All the inpatients with HB-related diseases were surveyed by cluster sampling of consecutive cases.The direct expenditure included direct medical cost and direct non-medical cost.The indirect expenditure,including work loss of patients and caregivers,were calculated by using human capital method for urban and rural populations in 12 areas.The intangible expenditure were reflected by willing to pay and stochastic tournament.The influencing factors of direct and indirect costs were identified by stepwise linear multi-variation regression analysis.Results A total of 27 hospitals in 12 areas were included in the survey.A total of 4 718 cases were surveyed,the overall response rate was 77.7％.The average hospital stay was 29.2 days (27-34) and the hospitalization expenditure was averagely 16 832.80 yuan (RMB) per case,in which the highest proportion (61.2％)was medicine fees [10 365.10 yuan (RMB)].The average direct expenditure and indirect expenditure were consistent with the severity of illness,which were 18 336.10 yuan (RMB) and 4 759.60 yuan (RMB) respectively,with the ratio of 3.85:1.The direct medical expenditure [17 434.70 yuan (RMB)] were substantially higher than the direct non-medical expenditure [901.40 yuan (RMB)].It was found that the hospitalization expenses was highest in direct medical expenditure and the transportation expenses was highest in direct non-medical expenditures.Among the average indirect expenditure,the loss of income for the patients [3 832.50 yuan (RMB)] was higher than that for the caregivers [927.20 yuan (RMB)],The total direct and indirect expenditure was highest for liver transplantation,followed by severe hepatitis,hepatocellular carcinoma and decompensated cirrhosis,acute hepatitis B,compensated cirrhosis and chronic hepatitis B.The influencing factors for both direct and indirect expenditure were high hospital level,severity of hepatitis B,living in urban area,antiviral therapy,long hospitalization and monthly income of family.For average 3.74 outpatient visits and 1.51 hospitalization,the average annual direct,indirect and intangible expenditure for HB-related diseases were 30 135.30,6 253.80 and 44 729.90 yuan (RMB) [totally 81 119.00 yuan (RMB)],accounting for 37.3％,7.7％ and 55.0％,respectively.Of the annual direct medical expenditure [28 402.80 yuan (RMB)],which were much higher than non-medical expenditure [1 732.50 yuan (RMB)],hospitalization expenditure [26 074.20 yuan (RMB)] was higher than outpatient visit expenditure [4 061.10 yuan (RMB)].The annual indirect expenditures for outpatient visit and hospitalization were 763.60 and 5 490.10 yuan (RMB),respectively.Of the annual intangible expenditure,the highest was that for/primary hepatocellular carcinoma,followed by cirrhosis,chronic hepatitis B,severe hepatitis B,liver transplantation and acute hepatitis B.Conclusions A heavy economic burden has been caused by HB-related diseases in China,and patients are more likely to rely on medical service rather than non-medical service.It is necessary to take effective treatment measures to prevent the adverse outcome of HB related diseases and achieve significant economic benefits.The influence of HB related diseases on mental health of the people can be reflected by an economics term,intangible expenditure.
ABSTRACT
During June 2012 to October 2014, a total of 48 patients with stones in common bile duct diagnosed by ultrasound and magnetic resonance cholangiopancreatography (MRCP) were randomly divided into two groups (n =24 each).The general group underwent conventional common bile duct exploration by laparoscopy (LCHTD) at left side.For improvement group, the operator timely transfered from left side to right side during laparoscopy.And two auxiliary holes of right side were used for suturing common bile duct.All patients successfully completed common bile duct exploration by laparoscopy.The suturing times of common bile duct were (13.6 ± 2.5) & (7.6 ± 2.7) min (t =11.365, P =0.000), intraoperative bleeding volume (77.52 ± 12.49) & (74.91 ± 13.66) ml (t =2.627,P =0.008), average peak temperature at day 3 post-operation (38.6 ± 0.5) & (37.4 ± 0.5) ℃ (t =9.954, P =0.000) and average postoperative hospitalization length (9.2 ± 3.4) & (7.1 ± 2.1) days (t =8.730, P =0.000).Compared with general group, the suturing time of common bile duct was significantly shorter in improvement group, the average highest temperature at day 3 post-operation were lower and complications (bile leakage, bile duct stricture & biliary tract bleeding) decreased significantly.The main hole conversion during common bile duct exploration by laparoscopy offers the advantages of flexibility, convenience and applicability.
ABSTRACT
Objective To explore the effects of low-sodium salt on blood pressure and to find out an economical,effective and easy-to-implement method to reduce the blood pressure.Methods This study was a randomized controlled study based on family unit.The participation families were recommended by local newspaper reporters and each family included at least 2 family members over 50 years old,who composed the objects of the study.The intervention group received two-month salt substitution intervention (with low sodium and high potassium) for free,while the control group received no intervention.Results The decrement of systolic blood pressure in intervention group was (4.7±10.9)mmHg,while the systolic blood pressure in control group was decreased by (2.6± 10.3)mmHg.The decline range of blood pressure was higher in the intervention group than in the control group,and there was a statistical significance in the difference (t=2.19,P＜0.05).Conclusions Salt substitution (with low sodium and high potassium) is an economical,effective and easy-to-implement method to reduce the blood pressure.Therefore,it is recommended to promote salt substitution (with low sodium and high potassium) in the crowd.
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Objective To explore the current situation of knowledge,attitude and behavior of smoking among the college student.Methods 1855 subjects,who were randomly chosen from colleges,were investigated with the questionnaire and analyzed the recognition and behavior of smoking.Results 1700 valid questionnaire were reclaimed.(effective rate 91.6%).The awareness of harmful components in the cigarette,such as nicotine,Tar cigarettes,had no difference among different grades (P＞0.05),but the recognition about the nitrogen oxides,carbon monoxide and radioactivity in higher grades was higher than that of lowers(P＜0.01,).The rate of smoking was 21.1% in total,there was no significant difference among different grades (P＞0.05).Conclusion Although the level of awareness about the harmful components in the cigarette and its harmness to health was different among different grades.Health education should be enforced in college students.