炎症性肠病(IBD)发病率的增加给中国患者带来了沉重的经济负担;然而,关于他们的财务状况和获得医疗保健的数据仍然缺乏。此信息对于告知IBD患者有关疾病治疗预算和医疗保健策略非常重要。
本研究的目的是通过中国克罗恩病与结肠炎基金会网络平台评估IBD患者的经济状况和医疗服务。
我们的研究是在2018年至2019年间通过微信在中国大陆的14个IBD中心进行的。参与者被要求完成64项基于网络的问卷。数据由文娟兴调查计划收集。我们主要关注收入和保险状况,医疗费用,以及与医疗保健提供者的接触。受访者按收入进行分层,并分析收入与医疗费用和急诊就诊时间的关系。
在这项研究中,3000名IBD患者,也就是说,1922年克罗恩病患者,973例溃疡性结肠炎,并纳入了105例未确定的结肠炎患者.在过去的12个月里,在中国,每位IBD患者的平均直接和间接成本(SD)约为11,668.68美元(7944.44美元)和74.90美元(253.60美元).大多数门诊和住院费用的平均报销比例不到50%。然而,85.5%(2565/3000)的患者每月收入低于10,000日元(1445美元).大约96.5%(2894/3000)的患者获得了健康保险,但只有24.7%(741/3000)的患者有私人商业保险,其中有较高的报销比率。近98.0%(2954/3000)的患者担心自己的财务状况。因此,79.7%(2392/3000)的IBD患者试图节省医疗费用,甚至推迟了医疗治疗。大约一半的受访者(1282/3000,42.7%)没有初级保健提供者,52.2%(1567/3000)的患者每年必须去急诊室1-4次治疗IBD。多变量分析显示,较低的收入(P=.001)和较高的交通(P=.004)和住宿费用(P=.001)与患者急诊就诊次数的增加显着相关。
中国IBD患者在获得医疗保健方面有巨大的经济负担和困难,这增加了他们的财务焦虑,不可避免地影响了他们的疾病结果。提前购买私人保险,从而提高了医疗费用的报销比例,发展远程医疗的使用将是节省医疗费用的有效策略。
The increasing incidence of inflammatory bowel disease (IBD) has imposed heavy financial burdens for Chinese patients; however, data about their financial status and access to health care are still lacking. This information is important for informing patients with IBD about disease treatment budgets and health care strategies.
The aim of this
study was to evaluate the economic status and medical care access of patients with IBD through the China Crohn\'s & Colitis Foundation web-based platform in China.
Our
study was performed in 14 IBD centers in mainland China between 2018 and 2019 through WeChat. Participants were asked to complete a 64-item web-based questionnaire. Data were collected by the Wenjuanxing survey program. We mainly focused on income and insurance status, medical costs, and access to health care providers. Respondents were stratified by income and the associations of income with medical costs and emergency visit times were analyzed.
In this
study, 3000 patients with IBD, that is, 1922 patients with Crohn disease, 973 patients with ulcerative colitis, and 105 patients with undetermined colitis were included. During the last 12 months, the mean (SD) direct and indirect costs for per patient with IBD were approximately US $11,668.68 ($7944.44) and US $74.90 ($253.60) in China. The average reimbursement ratios for most outpatient and inpatient costs were less than 50%. However, the income of 85.5% (2565/3000) of the patients was less than ¥10,000 (US $1445) per month. Approximately 96.5% (2894/3000) of the patients were covered by health insurance, but only 24.7% (741/3000) of the patients had private commercial insurance, which has higher imbursement ratios. Nearly 98.0% (2954/3000) of the patients worried about their financial situation. Thus, 79.7% (2392/3000) of the patients with IBD tried to save money for health care and even delayed their medical treatments. About half of the respondents (1282/3000, 42.7%) had no primary care provider, and 52.2% (1567/3000) of the patients had to visit the emergency room 1-4 times per year for the treatment of their IBD. Multivariate analysis revealed that lower income (P=.001) and higher transportation (P=.004) and accommodation costs (P=.001) were significantly associated with the increased number of emergency visits of the patients.
Chinese patients with IBD have enormous financial burdens and difficulties in accessing health care, which have increased their financial anxiety and inevitably influenced their disease outcomes. Early purchase of private insurance, thereby increasing the reimbursement ratio for medical expenses, and developing the use of telemedicine would be effective strategies for saving on health care costs.