目的综合分析和评价浙江省狂犬病暴露人群的经济负担,为卫生行政部门制定疾病防制策略提供量化依据。方法 2012年2-5月,通过文献调研和问卷调查等方法,收集浙江省40家犬伤门诊1 471份有效调查问卷,对犬伤暴露就诊者的一般特征进行描述性分析,并获得直接医疗费用、直接非医疗费用和误工间接经济负担。利用全省狂犬病疫情数据和统计年鉴,通过伤残调整生命年(DALY)结合人力资本的方法估算因早死引起的社会间接经济负担。结果狂犬病暴露人群直接医疗费用和直接非医疗费用的中位数分别为220.42元和16.24元(3%贴现率修正),直接非医疗费用中交通费所占比例最高,占76.10%;因误工引起的间接经济负担人均为135.96元(3%贴现率修正),其中家属误工损失占72.73%;因误工引起的浙江省狂犬病暴露后间接经济负担(全人口)约为7 748.70万元;因早死引起的浙江省狂犬病暴露后死亡间接经济负担(全人口)为1 576.76万元,其中45~和15~岁年龄组所占比例最高。平均每例狂犬病暴露后总经济负担为400.34元,其中直接医疗费用占总经济负担比例的59.12%,其次是误工引起的间接经济负担占33.97%。若Ⅲ级暴露后注射免疫球蛋白,经济负担将占到年收入的4%~20%,经济负担沉重。结论交通费所占直接非医疗费用比例最高,应合理布局犬伤门诊,其开设地点和数量应满足一定服务范围。家庭成本高于社会成本,直接经济负担特别是直接医疗费用是犬伤暴露后疾病经济负担的主要来源。有关部门应制定相关政策,帮助中低收入人群承担相关处置费用,提高就诊率,提高Ⅲ级暴露免疫球蛋白注射率。 OBJECTIVE: To comprehensively analyze and evaluate the economic burden of rabies-exposed population in Zhejiang Province and provide quantitative evidences for the development of disease prevention and control strategies by health administrative departments. Methods From January to May 2012, 1 471 valid questionnaires were collected from 40 dogs in Zhejiang province through literature survey and questionnaire survey, and the general characteristics of those who were exposed to canine injuries were analyzed descriptively. Expenses, direct non-medical expenses and indirect financial burden of lost time. Using the provincial rabies epidemic data and the Statistical Yearbook, the indirect financial burden caused by premature death is estimated through the DALY combined with human capital. Results The median direct medical costs and direct non-medical expenses for rabies exposed population were 220.42 yuan and 16.24 yuan respectively (3% discount rate revision). The direct non-medical expenses accounted for the highest proportion of transportation expenses, accounting for 76.10% Of the indirect economic burden per capita was 135.96 yuan (3% discount rate correction), of which 72.73% loss of family members of workers lost; due to the loss of Zhejiang Province caused by indirect economic burden of rabies exposure (population) is about 77.47 million yuan; due to premature death Of the indirect economic burden of death after exposure to rabies in Zhejiang Province (population) was 15.7766 million yuan, of which 45% and 15% of the age group accounted for the highest proportion. The average financial burden of each case of rabies after exposure was 400.34 yuan, of which direct medical costs accounted for 59.12% of the total economic burden, followed by 33.97% of the indirect economic burden caused by the loss of work. If the injection of immunoglobulin level Ⅲ exposure, the economic burden will account for 4% to 20% of annual income, the economic burden is heavy. Conclusion The proportion of direct non-medical expenses in transportation expenses is the highest, and the out-patient clinic should be arranged reasonably. The opening location and quantity should meet certain service scope. Household costs are higher than social costs, and the direct financial burden, especially direct medical costs, is the main source of economic burden of disease after canine injuries. Relevant departments should formulate relevant policies to help low-income groups bear the cost of disposal, improve the treatment rate, increase the grade III exposure immunoglobulin injection rate.