摘要
目的:分析农村贫困地区老年慢病患者的疾病直接经济负担及其影响因素,为减轻农村老年慢病人群疾病经济负担提出针对性建议。方法:于2018年7月采用多阶段分层随机抽样方法在西部和中部某省各两个国家级贫困县抽取≥60岁老年人家庭进行问卷调查,以其中2447名≥60岁且至少患一种慢病的老人为分析对象;通过方差分析比较样本对象在不同特征下的年人均疾病直接经济负担,并构建多重线性回归模型分析其直接经济负担的影响因素。结果:调查地区老年慢病患者年人均直接疾病经济负担为3156.0元;不同年龄、患慢性病共病情况、参保类型、就诊机构级别、住院机构级别、住院天数和失能程度样本对象直接经济负担的差异具有统计学意义(P<0.01);年龄、就诊机构级别、住院机构级别、住院天数和失能程度是直接经济负担的影响因素,除年龄与直接经济负担呈负相关外,其他因素均与之呈正相关。结论:农村老年慢病人群疾病经济负担有待进一步缓解,应重点保障农村地区贫困、高龄和失能慢病老人的医疗服务需求。
Objective To analyze the direct economic burden of the elderly patients with chronic diseases in impoverished rural areas and its influencing factors, and put forward suggestions for alleviating it. Methods In July 2018, the elderly aged over 60 and their family members were chosen from national poverty-stricken counties in central and western China with multistage stratified random sampling method, and surveyed with questionnaire. In which 2447 elderly with at least one chronic disease were analyzed with variance analysis and multiple linear regression. Results The annual per capita direct economic burden of the sampled elderly patients with chronic diseases was 3156.0 RMB Yuan. The direct economic burden was significantly different in different age, multimorbidity, types of insurance, level of medical institutions, level of inpatient institutions, inpatient duration and disability degree(P < 0.01). Age, level of medical institutions, level of inpatient institutions, inpatient duration and disability degree are factors to influence the direct economic burden, in which age is negatively correlated with the direct economic burden, while other factors are positively correlated with it. Conclusion The disease economic burden of the rural elderly with chronic diseases needs to be further alleviated. It is suggested to focus on ensuring the medical service demands of the poor, the senile and the disabled elderly people with chronic diseases in rural areas.
作者
李艾春
向琴
闫朝阳
马樱
王静
Li Aichun(Schoo of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,P.R.China)
出处
《中国卫生事业管理》
北大核心
2020年第12期927-931,共5页
Chinese Health Service Management
基金
国家自然科学基金面上项目“农村老年人健康贫困脆弱性多维风险识别及精准扶贫策略研究”(71673093)
教育部人文社会科学研究规划基金项目“农村老年人健康贫困多维风险识别及治理策略研究”(16YJA840013)
中央高校基本科研业务费资助(2016YXZD028)。
关键词
慢性病
疾病直接经济负担
老年人
农村
chronic diseases
direct economic burden
elderly people
rural area
