2014—2023年新疆棘球蚴病住院患者经济负担情况

doi:10.12140/j.issn.1000-7423.2026.02.019

中国寄生虫学与寄生虫病杂志 ›› 2026, Vol. 44 ›› Issue (2): 277-283.doi: 10.12140/j.issn.1000-7423.2026.02.019

2014—2023年新疆棘球蚴病住院患者经济负担情况

王乐¹()(), 古瑞娟², 童超³, 牛姜水⁴, 阿·孟克⁵, 苏晓红⁶, 任艳军⁷, 柳荆东⁸, 邓大伟⁹, 温浩¹^,^*()()

¹ 省部共建中亚高发病成因与防治国家重点实验室，新疆医科大学第一附属医院，新疆乌鲁木齐 830011
² 新疆医科大学第一附属医院，新疆乌鲁木齐 830011
³ 新疆伊犁哈萨克自治州友谊医院，新疆伊宁 835099
⁴ 巴州人民医院，新疆库尔勒 841000
⁵ 伊宁县人民医院，新疆伊宁 835099
⁶ 焉耆县人民医院，新疆焉耆 841100
⁷ 库车市人民医院，新疆库车 842000
⁸ 叶城县人民医院，新疆叶城 844900
⁹ 奇台县人民医院，新疆奇台 831800

收稿日期:2025-12-02 修回日期:2026-01-20 出版日期:2026-04-30 发布日期:2026-04-26
通讯作者: * 温浩（ORCID：0000-0001-7144-220X），男，博士，主任医师，从事棘球蚴病治疗及防控研究。E-mail：Dr.wen@163.com
作者简介:王乐（ORCID：0000-0002-8771-8212），女，博士，主任医师，从事棘球蚴病经济负担研究。E-mail：980790480@qq.com
作者贡献
王乐负责数据审核、整理分析、论文撰写，古瑞娟、童超、牛姜水、阿·孟克、苏晓红、任艳军、柳荆东、邓大伟负责数据收集和整理，温浩负责论文指导。
基金资助:
省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2022-41);新疆维吾尔自治区重点研发项目(2022B03013-3)

Economic burden of hospitalized patients with echinococcosis in Xinjiang from 2014 to 2023

WANG Le¹()(), GU Ruijuan², TONG Chao³, NIU Jiangshui⁴, A Mengke⁵, SU Xiaohong⁶, REN Yanjun⁷, LIU Jingdong⁸, DENG Dawei⁹, WEN Hao¹^,^*()()

¹ State Key Laboratory of Pathogenesis Prevention and Treatment of High Incidence Diseases in Central Asia;The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang, China
² The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang, China
³ Friendship Hospital of Ili Kazak Autonomous Prefecture, Yining 835099, Xinjiang, China
⁴ Bazhou People’s Hospital, Korla 841000, Xinjiang, China
⁵ Yining County People’s Hospital, Yining 835099, Xinjiang, China
⁶ Yanqi County People’s Hospital, Yanqi 841100, Xinjiang, China
⁷ Kucha City People’s Hospital, Kucha 842000, Xinjiang, China
⁸ Yecheng County People’s Hospital, Yecheng 844900, Xinjiang, China
⁹ Qitai County People’s Hospital, Qitai 831800, Xinjiang, China

Received:2025-12-02 Revised:2026-01-20 Online:2026-04-30 Published:2026-04-26
Supported by:
State Key Laboratory of Pathogenesis Prevention and Treatment of Central Asian High Incidence Diseases Open Project(SKL-HIDCA-2022-41);Xinjiang Uygur Autonomous Region Key Research and Development Project(2022B03013-3)

摘要/Abstract

摘要：

目的分析2014—2023年新疆棘球蚴病住院患者的经济负担情况，明确其经济负担的影响因素，为制定和完善新疆棘球蚴病治疗策略提供科学依据。方法采用分层抽样与便利性抽样相结合的方法，在新疆选取8家医院（三级甲等医院4家、二级甲等医院4家），收集2014年1月1日至2023年12月31日主要诊断为棘球蚴病的住院患者病案首页信息，包括性别、年龄、民族、住院天数、住院费用、医院等级、地区、是否手术、是否医保及棘球蚴病类型等。采用描述性统计方法分析患者人口学特征及费用分布；采用Mann-Whitney U检验和Kruskal-Wallis H检验进行单因素分析；采用对数多元线性回归模型（逐步法）分析住院费用的独立影响因素。采用伤残调整寿命年（DALY）结合人力资本法测算间接经济负担，间接经济负担 = 人均国民生产总值 × DALY × 生产力权重，采用SPSS 24.0软件进行统计学分析。结果共纳入棘球蚴病住院患者5 184例，2017年出院人数达峰值（865例），2022年降至最低点（230例，较峰值下降73.4%），2023年回升至361例。患者中位年龄为44岁，以45~59岁年龄组为主（32.9%，1 703例），男性占54.5%（2 823例），细粒棘球蚴病占90.1%（4 670例）。住院费用呈偏态分布，中位数从2014年的23 137.2元上升至2022年的34 921.0元。多房棘球蚴病患者平均住院费用（71 302.7元）高于细粒棘球蚴病（29 397.3元）（Z = -11.750，P < 0.05）；北疆地区患者平均住院费用（36 283.3元）高于南疆地区（17 703.7元）（Z = -19.701，P < 0.05）；住院超过30 d的患者费用均值最高（106 761.4元）（H = 1 263.033，P < 0.05）。对数多元线性回归分析显示，住院天数（标准偏回归系数 = 0.414）、是否手术（标准偏回归系数 = -0.471）、医院等级（标准偏回归系数 = 0.210）、地区、棘球蚴病类型、年龄、是否医保是住院费用的独立影响因素（校正后R² = 0.553，P < 0.05）。间接经济负担分析显示，研究期间棘球蚴病共造成10 007.3个DALY损失，人均损失2.0个DALY；15~44岁年龄组疾病负担最重，DALY损失合计5 465.0人年，占总DALY损失的54.6%。人力资本法测算结果显示，总间接经济负担为42 382.3万元，人均间接经济负担为8.2万元。结论新疆棘球蚴病患者经济负担呈现显著的结构性差异，多房棘球蚴病是导致高额医疗费用的核心病种，其资源消耗模式与细粒棘球蚴病存在本质区别。15~44岁青壮年群体承担了过半的生产力损失，是间接经济负担主要受影响人群。

关键词: 棘球蚴病, 住院费用, 间接经济负担, 影响因素

Abstract:

Objective To estimate the overall economic burden of echinococcosis patients in Xinjiang from 2014 to 2023 and to identify its influencing factors, so as to provide the scientific evidence for formulation and improvements of medical control strategies for echinococcosis in Xinjiang. Methods A total of 8 hospitals were sampled from Xinjiang by means of stratified sampling and convenience sampling, including 4 Class Ⅲ Grade A hospitals and 4 Class Ⅱ Grade A hospitals. Medical records were collected from hospitalized patients with a primary diagnosis of echinococcosis from January 1, 2014 to December 31, 2023, and variables were retrieved from medical records, including gender, age, ethnicity, length of hospital stay, hospitalization cost, hospital level, region, surgical treatment, health insurance status, and type of echinococcosis. Subjects’ demographics and cost distribution were analyzed with descriptive statistics. Univariate analysis was performed with Mann-Whitney U test and Kruskal-Wallis H test, and independent factors affecting hospitalization costs were identified using a logarithmic multiple linear regression model (stepwise method). Indirect economic burden was calculated with disability-adjusted life year (DALY) combined with the human capital method using the following formula: indirect economic burden = gross national product per capita × DALY × productivity weight. SPSS 24.0 was used for statistical analyses. Results A total of 5 184 hospitalized patients with echinococcosis were included. The number of patients discharging from hospital peaked in 2017 (865 cases), dropped to the lowest in 2022 (230 cases, a decrease of 73.4% compared with the peak), and rebounded to 361 cases in 2023. The subjects had a median age of 44 years, and were primarily at ages of 45 to 59 years (32.9%, 1 703 cases). Of all subjects, 54.5% (2 823 cases) were men, and 90.1% (4 670 cases) suffered from cystic echinococcosis. Hospitalization costs showed a skewed distribution, with the median increasing from 23 137.2 Yuan in 2014 to 34 921.0 Yuan in 2022. The mean hospitalization cost was higher for alveolar echinococcosis patients (71 302.7 Yuan) than for cystic echinococcosis patients (29 397.3 Yuan; Z = -11.750, P < 0.05), and the mean hospitalization cost was higher among patients from northern Xinjiang (36 283.3 Yuan) was higher than those from southern Xinjiang (17 703.7 Yuan)(Z = -19.701, P < 0.05). The highest mean cost was seen among patients with length of hospital stay exceeding 30 days (106 761.4 Yuan; H = 1 263.033, P < 0.05). Logarithmic multiple linear regression analysis identified length of hospital stay (β = 0.414), surgical treatment (β = ‒0.471), hospital level (β = 0.210), region, type of echinococcosis, age, and health insurance status as independent factors affecting hospitalization costs (adjusted R² = 0.553, P < 0.05). Indirect economic burden analysis showed that echinococcosis caused a total of 10 007.3 DALYs lost during the study period, with an mean loss of 2.0 DALYs per patient. Patients at ages of 15 to 44 years had the highest disease burden, with a total DALY loss of 5 465.0 person-years, accounting for 54.6% of the total loss. The total indirect economic burden was 423.823 million Yuan, with a mean indirect economic burden of 82 000 Yuan per patient. Conclusion The economic burden of echinococcosis patients shows significant structural differences in Xinjiang. Alveolar echinococcosis is the core disease type leading to high medical costs, and its resource consumption pattern is essentially different from that of cystic echinococcosis. Young and middle-aged populations at ages of 15 to 44 years have more than half of the productivity loss and is the main population affected by indirect economic burdens.

Key words: Echinococcosis, Hospitalization cost, Indirect economic burden, Influencing factor

中图分类号:

R532.32

王乐, 古瑞娟, 童超, 牛姜水, 阿·孟克, 苏晓红, 任艳军, 柳荆东, 邓大伟, 温浩. 2014—2023年新疆棘球蚴病住院患者经济负担情况[J]. 中国寄生虫学与寄生虫病杂志, 2026, 44(2): 277-283.

WANG Le, GU Ruijuan, TONG Chao, NIU Jiangshui, A Mengke, SU Xiaohong, REN Yanjun, LIU Jingdong, DENG Dawei, WEN Hao. Economic burden of hospitalized patients with echinococcosis in Xinjiang from 2014 to 2023[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2026, 44(2): 277-283.

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年份 Year	男 Male		女 Female		合计 Total
年份 Year	病例数 No. patient	构成比/% Constituent/%	病例数 No. patient	构成比/% Constituent/%	病例数 No. patient		构成比/% Constituent/%
2014	337	11.9	257	10.9	594	11.5
2015	305	10.8	275	11.6	580	11.2
2016	361	12.8	274	11.6	635	12.2
2017	465	16.5	400	16.9	865	16.7
2018	314	11.1	310	13.1	624	12.0
2019	325	11.5	279	11.8	604	11.7
2020	178	6.3	156	6.6	334	6.4
2021	199	7.0	158	6.7	357	6.9
2022	135	4.8	95	4.0	230	4.4
2023	204	7.2	157	6.6	361	7.0
合计 Total	2 823	100	2 361	100	5 184	100

民族 Nationality	细粒棘球蚴病 Cystic echinococcosis		多房棘球蚴病 Alveolar echinococcosis		合计 Total
民族 Nationality	病例数 No. patient	构成比/% Constituent/%	病例数 No. patient	构成比/% Constituent/%	病例数 No. patient	构成比/% Constituent/%
哈萨克族 Kazak	626	13.4	179	34.8	805		15.5
汉族 Han	1 838	39.4	187	36.4	2 025		39.1
回族 Hui	393	8.4	26	5.1	419		8.1
蒙古族 Mongol	277	5.9	59	11.5	336		6.5
维吾尔族 Uygur	1 379	29.5	34	6.6	1 413		27.3
其他 Other	157	3.4	29	5.6	186		3.6
合计 Total	4 670	100	514	100	5 184		100

影响因素 Influencing Factor	代码 Code	量化单位 Unit of Quantification
年龄 Age	X₁	岁 Years
住院天数 Length of stay	X₂	天 Days
性别 Gender	X₃	1 = 男 Male 2 = 女 Female
医院等级 Hospital level	X₄	1 = 二级甲等 Class Ⅱ Grade A 2 = 三级甲等 Class Ⅲ Grade A
地区 Region	X₅	1 = 北疆 Northern Xinjiang 2 = 南疆 Southern Xinjiang
是否手术 Surgical procedure	X₆	1 = 手术 Yes 2 = 未手术 No
是否医保 Health insurance	X₇	1 = 是 Yes 2 = 否 No
棘球蚴病类型 Type of echinococcosis	X₈	1 = 细粒棘球蚴病 Cystic echinococcosis 2 = 多房棘球蚴病 Alveolar echinococcosis

变量 Variable	偏回归系数 Partial regression coefficient	偏回归系数标准误 Standard error of partial regression coefficient	标准偏回归系数 Standardized partial regression coefficient	t	P
常项量Constant	9.146	0.097		94.665	0
年龄Age	0.004	0	0.07	7.331	0
住院天数 Length of stay	0.039	0.001	0.414	40.749	0
性别Gender	-0.014	0.017	-0.008	-0.823	0.411
医院等级Hospital level	0.796	0.037	0.21	21.549	0
地区Region	-0.287	0.026	-0.11	-11.237	0
是否手术Surgical procedure	-1.363	0.029	-0.471	-46.697	0
是否医保 Health insurance	0.106	0.021	0.047	5.029	0
棘球蚴病类型Type of echinococcosis	0.351	0.031	0.113	11.446	0

年度 Year	病例数 No. patient	人均GNP/元 Gross national product per capita/CNY	伤残调整寿命年 DALY		间接经济负担/万元 Indirect economic burden/10 000 CNY
年度 Year	病例数 No. patient	人均GNP/元 Gross national product per capita/CNY	人均 Per Capita	合计 Total	人均 Per Capita	合计 Total
2014	594	46 971	1.7	1 008.6	5.4	3 186.6
2015	580	49 684	2	1 156.3	6.7	3 901.2
2016	635	53 516	2.1	1 314.6	7.3	4 667.1
2017	865	59 514	1.7	1 478.8	6.7	5 801.1
2018	624	65 246	1.8	1 107.0	7.6	4 726.6
2019	604	69 881	1.7	1 020.7	7.5	4 515.4
2020	334	71 253	1.8	607.0	7.8	2 588.9
2021	357	80 803	2.0	725.7	11.1	3 953.8
2022	230	84 579	2.8	36.3	1.6	3 682.3
2023	361	88 607	2.6	952.4	1.6	5 725.3
合计	5 184	60 716	2.0	10 007.3	8.2	42 382.3

2014—2023年新疆棘球蚴病住院患者经济负担情况

Economic burden of hospitalized patients with echinococcosis in Xinjiang from 2014 to 2023

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