| Objective:The aim of this study was to understand the epidemic features and trends of HBVrelated diseases,and evaluate it' s disease burden.Investigate hepatitis b related disease inpatients' economic burden and influencing factors.Provide possible prevention strategies and measures for relevant health department.Methods:Retrospectively collected the incidence data,death data,and population data of hepatitis B-related diseases from 2008 to 2019 in Changchun to calculate the standardized incidence and mortality,analyze their epidemic trends,and draw change curves.Years of life lost(YLLs),years of lived with disability(YLDs)and disability adjusted life years(DALYs)were calculated to estimate the health burden of hepatitis B-related diseases.The survey questionnaires and electronic medical records was used to investigate the direct and indirect financial burden of inpatients with hepatitis Brelated diseases.Multiple linear stepwise regression analysis was used to analyze the influencing factors of financial burden.Results:1.The highest incidence and standardized incidence of hepatitis B in Changchun of past ten years were 53.57/100,000 and 50.38/100,000 appeared in 2012,The lowest incidence and standardized incidence were 22.02/100,000 and 20.70/100,000 o appeared in 2017.Incidence of hepatitis B was higher in men than in women.The peak age-specific incidence from 2009 to 2012 were all appeared in 30-49 age group,which were 65.06//100,000,67.08//100,000,64.28//100,000 and 67.88//100,000 respectively.The age groups of 5-14,15-29,and 30-49 years were the lowest levels in nearly 10 years in 2018,which were 0.86 / 100,000,12.48 / 100,000 and 30.11 / 100,000,respectively.The 5-14,15-29,and 30-49 age groups were the lowest levels over the ten years appeared in 2018,which were 0.86/100,000,12.48/100,000 and 30.11/ 100,000,respectively.2.Over the last five years,the highest mortality of hepatitis B was 0.86/100,000 appeared in 2018,the lowest mortality of hepatitis B was 0.31/100,000 appeared in 2017.The highest mortality of HBV-related cirrhosis was 3/100,000 appeared in 2016,the lowest mortality of hepatitis B was 2.42/100,000 appeared in 2018.The highest mortality of HBV-related liver cancer was 14.97/100,000 appeared in 2015,the lowest mortality of hepatitis B was 13.75/100,000 appeared in 2014.Mortality of three HBVrelated diseases were all higher in men than in women.3.The DALYs of hepatitis B,HBV-related cirrhosis and HBV-related liver cancer were 7697.5,2319.9 and 12723.7 in 2018 Changchun.The DALY rate of hepatitis B,HBV-related cirrhosis and HBV-related liver cancer were 98.0/100,000,29.5/100,000 and 161.9/100,000,respectively.The DALYs of hepatitis B are mainly composed of YLDs(89.91%),while the DALYs of hepatitis B cirrhosis and hepatitis B cancer are mainly composed of YLLs,accounting for 95.29% and 99.20%,respectively.4.The median direct financial burden of this time hospitalization for patients with HBV-related diseases was 21827.7 yuan,the median indirect economic burden of this time hospitalization was 2728 yuan,and the median total financial burden of this time hospitalization was 24747.7 yuan.The median direct financial burden of this hospitalization for patients with decompensated HBV cirrhosis was the highest(27469.7 yuan),and the lowest was patients with HBV cirrhosis(17691.2 yuan).Type of disease,gender and length of hospital stay were the influencing factors for the financial burden of this time hospitalization for HBV-related diseases.5.The median annual direct financial burden of patients with HBV-related diseases is 26309.3 yuan,the median annual indirect financial burden is 3806.5 yuan,and the total median annual economic burden is 29641.6 yuan.The median annual direct financial burden of patients with hepatitis B liver cancer was the highest(53383.6 yuan),and the lowest was in patients with acute hepatitis B(24127.6 yuan).Type of disease,and the length of hospital stay were the influencing factors of the annual financial burden of HBV-related diseases.Conclusions:1.The incidence of hepatitis B in Changchun City showed and undulate but overall downward trend.The incidence of men was consistently higher than women.The peak incidence of hepatitis B appears to shift back within the age group over past ten years.2.The mortality of hepatitis B in Changchun City showed an upward trend;the overall mortality HBV-related cirrhosis showed a downward trend;and the mortality of HBV related liver cancer increased,and then a slow decline.The mortality of three diseases were higher in man than women in the past five years.3.The huge loss of healthy life span caused by HBV-related diseases in Changchun City.Among them,the disease burden caused by hepatitis B was the heaviest,followed by hepatitis B,and liver cirrhosis is the lightest.4.The financial burden of patients with HBV-related diseases in Changchun City is heavy,exceeding the disposable income per capita and the annual household income per capita.5.Controlling the progress of the disease and reducing the length of hospital stay can reduce the financial burden of patients with HBV-related diseases. |
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