Abstract: Background　With the development of economy and the aggravation of aging，the prevalence of noninfectious chronic diseases（NCD）is increasing.Patients with NCD need to have clinical treatment and health management，such as drug use，self-monitoring，clinical examination，medical treatment and self-management，which may cause a heavy burden on patients.Objective　To explore the status of treatment burden and its influencing factors of patients with NCD in Chang'an Town，Dongguan，Guangdong.Methods　Taking Chang'an Town，Dongguan，Guangdong as the research site，a multistage stratified cluster random sampling was adopted to select 4 to 6 cell from each of the 13 communities，and 50 families were randomly selected from each cell by cluster sampling method.Finally a total of 1 472 patients with NCD were included in the study in July 2016.Patients were investigated using NCD patients treatment burden questionnaire，which included general demographic questionnaire，NCD status questionnaire，health service utilization questionnaire，and Treatment Burden Questionnaire （TBQ）．Results　According to the status of treatment burden，patients were divided into low treatment burden group（721 cases），moderate treatment burden group （540 cases） and heavy treatment burden group （211 cases） by K-means cluster analysis，and TBQ scores of three groups were （24.4±10.5），（53.6±9.3） and （85.1±13.6），respectively.There were significant differences in treatment burden in terms of medical insurance，chronic pain，musculoskeletal and connective tissue diseases，different kinds of chronic diseases，non-hospitalization and hospitalization in 12 months （P<0.05）．The result of Ordinal Logistic regression analysis showed that employee insurance〔OR=-1.046，95%CI （-1.786，-0.306）〕，medical insurance〔OR=-0.767，95%CI （-1.449，-0.086）〕，suffering one chronic diseases 〔OR=-0.364，95%CI （-0.660，-0.070）〕 and hospitalization in 12 months 〔OR=0.605，95%CI （0.250，0.960）〕 were the factors influencing the treatment burden of patients with NCD （P<0.05）．Conclusion　Patients with NCD in Chang'an Town，Dongguan mainly have low treatment burden.Medical institutions should strengthen the monitoring of NCD and health management of patients with NCD，so as to reduce the burden of treatment and improve health of patients.

Key words: Noninfectious chronic disease, Cost of illness, Ordinal Logistic regression, Current situation research

摘要： 背景　随着社会经济的发展和老龄化的加剧，慢性非传染性疾病（NCD）的发病率逐年上升，NCD需面临服用药物、自我监测、临床检查、就诊和自我管理等临床治疗和健康管理，给患者造成沉重的负担。目的　探讨广东省东莞市长安镇NCD患者的治疗负担情况及影响因素。方法　2016年7月以广东省东莞市长安镇为研究点，采用多阶段分层整群随机抽样方法从13个社区各抽取4~6个小区，采用整群抽样方法每个小区随机抽取50户家庭，共纳入1 472例NCD患者。采用NCD患者治疗负担调查问卷对患者进行调查，包括一般人口学调查表、NCD情况调查表、卫生服务利用调查表、治疗负担量表（TBQ）。结果　采用K类中心聚类分析法根据治疗负担程度将患者分为轻度组（721例）、中度组（540例）、重度组（211例），其中，轻度组TBQ总分为（24.4±10.5）分，中度组TBQ总分为（53.6±9.3）分，重度组TBQ总分为（85.1±13.6）分。３组医保类型构成情况、慢性疼痛、骨骼及结缔组织炎症、患NCD种数、近12个月内需住院而未住院、近12个月内住院所占比例比较，差异均有统计学意义（P<0.05）。Ordinal Logistic回归分析结果显示，城镇职工医保〔OR=-1.046，95%CI（-1.786，-0.306）〕、城镇居民医保〔OR=-0.767，95%CI（-1.449，-0.086）〕、患NCD种数为1种〔OR=-0.364，95%CI（-0.660，-0.070）〕和近12个月内住院〔OR=0.605，95%CI（0.250，0.960）〕是NCD患者治疗负担的影响因素（P<0.05）。结论　东莞市长安镇NCD患者治疗负担以轻度治疗负担为主，医疗机构应加强NCD的监控和NCD患者健康管理，以达到降低患者的治疗负担、提高健康水平的目的。

关键词: 慢性非传染性疾病, 患病代价, Ordinal Logistic回归, 现状研究