摘要
目的 基于广东省河源市"联爱工程"慈善医疗救助项目,了解儿童白血病家庭因病致贫情况并分析其影响因素,评价慈善医疗救助对因病致贫的缓解效果.方法 整群选取2017-08-15-2022-06-30参与项目救助、河源市户籍、年龄＜18岁、处于维持期或停药期的85例白血病患儿及照顾者作为干预组,招募未参与项目、年龄＜18岁、户籍为云浮市或汕尾市、基本医疗保险所在地与户籍所在地一致、治疗阶段是维持期或停药期的36例白血病患儿及照顾者为对照组.通过问卷调查和项目报销数据收集干预组和对照组患儿及家庭的相关信息,采用x2检验、单因素和多因素logistic回归分析2组家庭因病致贫情况及影响因素.结果 医保报销后,干预组和对照组因病致贫发生率分别为31.76％和75.00％;因病致贫总缺口分别为12.27和21.37万元,平均缺口分别为0.14和0.59万元;医保报销前后,2组家庭因病致贫发生率干预组均低于对照组,差异具有统计学意义,P＜0.001.干预组经项目补充报销后,因病致贫发生率降至21.18％,与医保报销后的对照组指标水平差异有统计学意义,P＜0.001;因病致贫总缺口和平均缺口分别降至8.82和0.10万元.亚组分析显示,治疗阶段和确诊后是否为贫困户2个特征的差异对因病致贫发生率不会产生较大影响.是否移植、确诊至今的时间、去医院就诊的频率、是否接受项目救助是影响儿童白血病家庭发生因病致贫的影响因素.结论 广东省河源市儿童白血病家庭因病致贫发生率较高,慈善医疗救助在医保报销的基础上发挥了积极的经济补偿作用.
Abstract
Objective Based on the"United Love Program"charity medical assistance program in Heyuan City,to under-stand the disease-induced poverty in children with leukemia and analyze its influencing factors,and to evaluate the mitiga-tion effect of charity medical assistance on disease-induced poverty.Methods A total of 85 children with leukemia and their caregivers,who met the following inclusion criteria:receiving the program assistance from August 15,2017 to June 30,2022,registered in Heyuan City,aged＜18,and being in the maintenance period or drug withdrawal period,were se-lected as the intervention group.Totally 36 children with leukemia and their caregivers,who met the following inclusion criteria:not receiving the program assistance,aged＜18,registered in Yunfu City or Shanwei City,the insured place be-ing the same as the place of household registration,and being in the maintenance period or drug withdrawal period,were recruited as the control group.The relevant information of children and their families in the intervention group(who re-ceived the program assistance)and the control group(who did not receive the program assistance)were collected through questionnaire survey and program reimbursement data.Chi-square test,single factor and multiple logistic regression models were used to analyze the disease-induced poverty and its influencing factors in the two groups.Results After medical in-surance reimbursement,the incidence of disease-induced poverty in the intervention group and the control group was 31.76％and 75.00％,respectively.The total gap of disease-induced poverty was CNY 122 700 and CNY 213 700,respec-tively,and the average gap was CNY 0.14 thousand and CNY 0.59 thousand,respectively.Before and after medical in-surance reimbursement,the difference in the incidence of disease-induced poverty between the two groups was statistically significant(P＜0.001),and the intervention group was lower than the control group.After the supplementary reim-bursement of the program,the incidence of disease-induced poverty in the intervention group decreased to 21.18％,which was statistically different from the control group after medical insurance reimbursement(P＜0.001).The total gap and average gap of disease-induced poverty decreased to CNY 88 200 and CNY 0.10 thousand,respectively.Subgroup analy-ses showed that differences of two characteristics,the treatment stage and whether or not the family was poor after diag-nosis,did not have a significant impact on the incidence of disease-induced poverty.Whether or not receiving transplant,the time since the diagnosis,the frequency of visiting hospitals,and whether or not receiving program assistance were sta-tistically significant factors affecting the incidence of disease-induced poverty in children with leukemia.Conclusions The incidence of disease-induced poverty among children with leukemia in Heyuan City,Guangdong province is high.Charita-ble medical assistance plays an active role in financial compensation on the basis of medical insurance reimbursement.
基金项目
山东大学青年交叉科学创新群体(2020QNQT019)
联爱工程"儿童白血病综合控制"项目实施评价研究()
NETL
NSTL
万方数据