摘要
目的了解陕西省中老年高血压患者服药情况及主要影响因素,分析影响因素对服药不平等性的贡献程度。方法利用陕西省2013年第五次卫生服务调查数据,采用序次logistic回归分析中老年高血压患者服药行为及影响因素,运用集中指数测量中老年高血压患者服药不平等程度,并利用集中指数分解法探讨影响因素对服药不平等的贡献。结果陕西省2013年中老年人群高血压患病率为20.50%;高血压患者按医嘱服药率为58.46%;地区、年龄、婚姻状况、受教育程度、就业状态、医疗保险、经济水平、饮酒、锻炼情况、自评健康得分因素对中老年高血压患者服药影响显著(P<0.05)。中老年高血压患者服药集中指数为0.01562;经济水平、医疗保险、地区和受教育程度对服药不平等的贡献率较大,分别为49.71%、21.26%、18.54%和11.17%,各因素增加了偏向富人的不平等;其中,经济水平对服药不平等的贡献最大。结论陕西省中老年高血压患者按医嘱服药率较低,并存在偏富人的不平等。改善经济状况,缩小贫富差距,完善医疗保险,提供均等的受教育机会,有利于中老年高血压患者服药不平等性的改善。
Objective To study the status and influencing factors of medication among middle-aged and elderly hypertension patients in Shaanxi province and to explore the contributions of the factors influencing the medication inequality in the patients.Methods The data on 5774 hypertension patients aged≥45 years were derived from the Fifth National Health Services Survey conducted in 2013 among 20700 households recruited with stratified random sampling in 32 counties/districts across Shaanxi province.Ordinal logistic regression was used to explore influencing factors of medication among the patients.Concentration index(CI)was employed to assess medication inequality and decomposition of CI was adopted to evaluate the contributions of influencing factors of medication inequality among the patients.Results The prevalence rate of hypertension was 20.50%among the≥45 years old participants of the survey in 2013.Of all the hypertension patients identified in the survey,58.46%reported regular medication recommended by doctors.Ordinal logistic regression analysis demonstrated that residential region,age,marital status,education,employment,medical insurance,economic condition,alcohol drinking,physical exercise,and self-rated health were significant influencing factors of hypertension medication(P<0.05 for all).The CI of medication was 0.01562 for all the hypertension patients;the correlates with higher contribution to medication inequality were economic condition(positive percentage of contribution to CI:49.71%),medical insurance(21.26%),residential region(18.54%),and 11.17%and all the correlates increased the pro-rich inequality of hypertension medication.Conclusion The proportion of regular medication was low and there was a pro-rich medication inequality among middle-aged and elderly hypertension patients in Shaanxi province;improvement in economic condition,medical insurance and education could reduce the medication inequality in the hypertension patients.
作者
闫菊娥
徐甜鸽
任杨玲
耿顺利
刘晓彤
YAN Ju-e;XU Tian-ge;REN Yang-ling(School of Public Policy and Administration,Xi'an Jiaotong University,Xi'an,Shaanxi Province 710049,China)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2020年第1期110-114,共5页
Chinese Journal of Public Health
关键词
中老年高血压患者
服药
影响因素
不平等性
集中指数
分解
middle-aged and elderly hypertension patients
medication
influencing factor
inequality
concentration index
decomposition analysis
