The Study On The Economic Burden Of Diabetes Mellitus And Its Influencing Factors In Zhuhai

1 ObjectiveTo explore the current economic burden of diabetic patients in Zhuhai,to analyze the factors which impact on the economic burden of diabetes,for formulating policies to reduce the economic burden of diabetic patients,then put forward scientific and reasonable suggestions and opinions.2 method(1)Source: literature review,questionnaires,outpatient and inpatient billing system inquiries.(2)Survey method: The survey was conducted by using multi-stage sampling method.A total of 330 diabetic patients were interviewed from face-to-face interviews in Xiangzhou District,Jinwan District and Doumen District,Zhuhai.and 314 questionnaires were valid.The vaild rate was 95.2%.(3)Statistical methods: including single factor rank test,chi-square test analysis method,multiple linear regression and logistic regression analysis method.3 Results(1)A total of 314 diabetic patients were analyzed in this study,of which 139 were surveyed in Xiangzhou District,accounted for 44.3%,compared with 85 cases in Jinwan District(accounted for 27.1%),90 cases in Doumen District(accounted for 28.7%);150 in male patients(accounted for 47.8%),164 cases of female patients(accounted for 52.2%);18 cases were24-40 years old(accounted for 5.7%),86 cases were 41-55 years old(accounted for 27.4%),168 cases were 56-70 years old(accounted for 53.5%),42 cases were 71 years old or more older(accounted for 13.4%).The majority of the respondents are Han nationnality,accounted for96.2%;educational level in primary and below accounted for 48.1%,secondary accounted for44.6%,college and above accounted for 7.3%.Per capita annual income mostly in 15,000 yuan(51.6%),15000-30000 yuan accounted for 31.2%,30001-45000 yuan accounted for 9.2%,more than 45,000 yuan accounted for 8.0%.(2)The annual economic burden of diabetic patients in Zhuhai was 5651.2 yuan,accounted for 4.2% of the per capita GDP of Zhuhai in 2016,accounted for 14.1% of the per capitadisposable income of Zhuhai.The direct economic burden was 4899.2 yuan(86.7%),the indirect economic burden was 752.0 yuan(13.3%);the total economic burden of the disease was 0.92 billion yuan.(3)The self-management of diabetic patients needed to be strengthened,176 diabetic patients in Zhuhai with BMI index of overweight and above,accounted for 56.1%.Only 37.3%of diabetic patients paid attention to daily energy intake and food categories.9.8% of patients did not commanded the current changes in body weight.39.5% of patients did not monitor daily blood glucose,38.4% of patients did not do any exercise.(4)According to the analysis of multiple linear regression model,the independent foctors affected direct economic burden of diabetic patients in Zhuhai were duration of diabetes(β =0.114,95%CI= 0.014~0.213),whether to use insulin(β = 0.453,95%CI = 0.262~0.644),whether drunk(β = 0.225,95%CI = 0.020~0.431),the level of the medical institution(β = 0.358,95%CI= 0.271~0.444),the level of the hospitalized institution(β = 0.218,95%CI = 0.052~0.384),hospitalization days(β = 0.062,95%CI = 0.025~0.098).(5)According to the logistic regression model,the independent factors affected the quality of life of patients with diabetes in Zhuhai were whether had complications(OR=2.679,95%CI=1.653~4.733),whether hospitalized with diabetes(OR=3.693,95%CI=1.767~7.719),with or without other chronic diseases(OR=2.797,95%CI=1.528~4.696).Compared with patients who have been ill for less than 5 years,the patients who have been ill for 6-10years(OR=2.550,95%CI=1.385~4.694)and who have been ill for more than 10 years(OR=2.795,95%CI=1.433~5.454)were paid more about the diabetes.4 ConclusionsThe current level of economic burden of diabetes in Zhuhai was roughly the same as the other parts of the country.The annual per capita financial burden of diabetic patients in Zhuhai was 5651.2 yuan,accounted for 4.2% of the per capita GDP in Zhuhai in 2016.However,some patients in Zhuhai lack of awareness of self-management,short for awareness of disease screening and the refused visit medical institutions at the grass-roots level.And the costs of the primary medical institutions were far lower than general hospital.Therefore,We should strengthen the health education of diabetes,and guide patients to form a reasonable healthy living habits,reduce the incidence of complications in patients,improve the diagnosis andtreatment ability of medical institutions,reduce the frequency of hospitalization and length of stay.In order to reduce the direct and indirect economic burden,we should continue to implement Hierarchical Diagnosis Sysetem.