The Quality Of Life And Economic Burden Of Occupational Diseases And Related Factors

【Objective】 To investagate the quality of life, direct and indirect economic burden, epidemiological burden of inpatients with occupational diseases in Shandong Province, analyses the affecting factors on the quality of life and disease burden, and propose effective measures improving the quality of life and reducing disease burden of patients.【Methods】By cluster sampling method,255 cases of inpatients who had occupational diseases from four hospitals in Shandong Province were selected. Using self-made general condition questionnaire, World Health Organization Quality of Life Brief Scale(WHOQOL-BREF),we investigated patients’ general condition, fees, quality of life. The obtained data were inputed into Epidata3.1 database by dual record,we quantitatively analyzed the quality of life of patients, calculated the burden of disease from both epidemiology and economics analysed by SPSS17.0 statistical analysis software. Through T-test, F-test, ANOVA,multivariate regression analysis.【Results】1 WHOQOL-BREF reliability test World Health Organization Quality of Life Brief Scale(WHOQOL-BREF) krona Bach αreliability coefficients’ corresponding value in physiology, psychology, social relations, environment areas and two independent questions which comprehensively evaluate quality of life were 0.81, 0.78, 0.68, 0.80, 0.81.It indicated that the scale had good internal consistency and be suitable for to this investigation. 2 Quality of Life 2.1 The occupational diseases patients’ Quality of Life( QOL) scores in all areas are in the order, social sphere(11.48±2.86), psychological field(10.60±2.28), physical domain(10.54±1.65), and environmental field(10.5±2.55), significantly lower than the norm(p <0.05). 2.2 There was no significant difference(P> 0.05) in QOL scores of occupational disability level. The significant difference(P> 0.05) in QOL scores of three groups with pneumoconiosis(stage I,stage II,stage III)was not found.Pneumoconiosis patients were divided into three groups according to mild, moderate and severe pulmonary dysfunction, their corresponding QOL scores were significant difference(P<0.05), and QOL scores of mild pulmonary dysfunction in physical and environment field were significantly higher than moderate and severe lung dysfunction(P<0.05).Occupational poisoning patients are divided into mild, moderate, severe groups according to diagnostic criteria, their QOL values showed no significant difference(p> 0.05). 2.3 Multiple regression analysis showed that the main influence factors of QOL scores are lung dysfunction, complications, duration of disease, age, income and employment status. 3 Burden of occupational diseases 3.1 The direct economic burden of patients average are 88562±61760 yuan per person per year. Disability-adjusted life year(DALY) are 12.95±8.08 person-years. Social indirect economic losses average are 367586±229618 yuan. 3.2 Direct economic burden of stage Ⅱ, stage Ⅲpneumoconiosis patients were higher than that of stageⅠ(P <0.05). Direct economic burden of high levels of occupational disability were higher than that of low level of disability(P <0.05).Epidemiological burden of occupational diseases with complications were higher than those without complications(P <0.05). 3.3 The main factors affecting the direct economic burden of occupational disease patients were days in hospital, nursing staff, nutrition fee, the extent of disease (pneumoconiosis stage and poisoning indexing)(P<0.05). Epidemiological burden influencing factors mainly include age, lung function, situation of accompanying persons(P <0.05).【Conclusions】 1 Quality of life in patients with occupational diseases decreased obviously. Improve the quality of life of patients with emphasis on the treatment of complications, pulmonary rehabilitation, functional rehabilitation, restoration of social function as soon as possible. 2 There is an increasing trend on occupational diseases’ burden in accord with economic development. To reduce the disease burden of patients with occupational diseases, we must focus on the adjustment of hospital management and standard treatment.