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目的估计广州市严重急性呼吸道综合征(SARS)临床确诊病例的直接经济负担和间接经济负担,为急性传染性疾病疾病负担估计建立方法。方法收集2003年SARS暴发流行期间1 059例SARS确诊病例的有关资料。对399例愿意配合的患者进行问卷调查;将伤残调整寿命年(DALYs)和误工损失通过人力资本法折算为经济损失,评估SARS病例的直接和间接的经济损失。结果1 059例SARS确诊病例的人均住院费用20 263.56元,日均住院费用1 160.57元;339例SARS病人的人均门诊费用为463.43元,人均复查费用848.28元;自行购买营养品、药品等人均花费2 646.91元。推算广州市2003年1 283例SARS病例的直接经济负担为3 107.59万元;SARS死亡病例因早死造成的寿命损失年(YLLs)为654.71,经济损失1 489.43万元;SARS存活病例平均误工时间为51.76 d,经济损失为577.48万元,间接经济损失共2 067.44万元。有34.2%被调查者回答愿意倾全部财产避免罹患SARS,表明SARS给患者造成的伤害无法用金钱衡量;另有26.3%的病人愿出1万元以上换取不患SARS。结论综合直接经济负担和间接经济负担,广州市SARS临床确诊病例的总经济负担为5 175.03万元,人均4.03万元。
Objective To estimate the direct economic burden and indirect financial burden of clinically confirmed cases of severe acute respiratory syndrome (SARS) in Guangzhou and to establish a method for estimating the burden of disease in acute infectious diseases. Methods The data of 1 059 confirmed cases of SARS during the epidemic of SARS in 2003 were collected. A questionnaire survey was conducted on 399 patients who were willing to cooperate. The DALYs and loss of working life were converted into economic losses through the Human Capital Law to assess the direct and indirect economic losses of SARS cases. Results The per capita hospitalization cost of 1 059 SARS cases was 20 263.56 yuan and the average daily hospitalization cost was 1 160.57 yuan. The per capita outpatient expense of 339 SARS patients was 463.43 yuan and the average per capita review cost was 848.28 yuan. The per capita cost of self-purchased nutrition products and medicines 2 646.91 yuan. The direct economic burden of 1 283 cases of SARS in Guangzhou was estimated to be 3,107,900 yuan in 2003; the annual loss of life expectancy (YLLs) due to premature death from SARS was 654.71 and the economic loss was 14,849,300 yuan; the average time lost for SARS survivors was 51.76 d, economic loss of 5774800 yuan, a total of 20674400 yuan of indirect economic losses. 34.2% of the respondents responded that they were willing to dump all their property to avoid SARS, indicating that the SARS injury to patients can not be measured by money; another 26.3% of patients would like to have more than 10,000 yuan in exchange for not suffering from SARS. Conclusion The total economic burden of clinical diagnosis of SARS in Guangzhou is 51,75300 yuan, with a per capita population of 40,300 yuan, taking into account the direct economic burden and the indirect economic burden.