目的分析2012—2023年重庆市老年人自杀死亡率与死亡疾病负担变化趋势,为开展有针对性的干预提供建议。方法利用重庆市2012—2023年死因监测数据中根本死因为自杀(《国际疾病与相关健康问题统计分类第10版》编码:X60~X84、Y87)的60岁及...目的分析2012—2023年重庆市老年人自杀死亡率与死亡疾病负担变化趋势,为开展有针对性的干预提供建议。方法利用重庆市2012—2023年死因监测数据中根本死因为自杀(《国际疾病与相关健康问题统计分类第10版》编码:X60~X84、Y87)的60岁及以上老年人死亡个案,分析死亡率、标化死亡率、早死寿命损失年(years of life lost,YLL)率、平均寿命损失年(average years of life lost,AYLL)及不同死因构成比,比较不同性别和地区死亡率,率的趋势变化采用年度变化百分比(annual percent of change,APC)和平均年度变化百分比(average annual percent of change,AAPC)进行分析。结果2012—2023年60岁及以上老年人自杀死亡率与标化死亡率总体呈下降的趋势,分别以年均3.54%与4.02%下降,变化趋势均有统计学意义(P<0.05)。2012—2016年自杀死亡率以年均4.53%上升,2016—2021年以年均8.91%下降,变化趋势均有统计学意义(P<0.05)。仅2020年与2022年男性自杀死亡率高于女性(P<0.05)。2012—2023年男性自杀死亡率与标化死亡率分别以年均2.86%和3.44%下降,女性分别以年均4.21%和4.69%下降,变化趋势均有统计学意义(P<0.05)。农村地区老年人历年自杀死亡率均高于城市地区,差异均有统计学意义(P<0.05)。2012—2023年城市地区老年人自杀死亡率与标化死亡率均保持相对平稳的水平(P>0.05),而农村地区老年人自杀死亡率与标化死亡率分别以年均3.44%与4.02%下降(P<0.05)。60岁及以上老年人自杀导致的YLL率与AYLL分别由2012年的3.03‰与18.54年下降至2023年的2.26‰与17.50年,AAPC分别为-4.02%与-0.60%,变化趋势均有统计学意义(P<0.05)。比较历年不同自杀方式构成发现,杀虫剂中毒死亡占比呈下降的趋势,而悬吊死亡、从高处跳下、淹溺占比均呈上升的趋势(P<0.05)。结论重庆市60岁及以上老年人自杀死亡率较高,疾病负担较重,总体呈下降的趋势,应重视老年人自杀的早期识别与干预。展开更多
明确疾病负担对于确定卫生工作的重点及优化医疗资源的配置至关重要,但研究方法和假设的差异往往会影响疾病研究结果间的可比性,进而导致卫生决策困境。伤残调整生命年(DALY)是测量疾病负担最常用的指标,但使用DALY指标的疾病负担研究...明确疾病负担对于确定卫生工作的重点及优化医疗资源的配置至关重要,但研究方法和假设的差异往往会影响疾病研究结果间的可比性,进而导致卫生决策困境。伤残调整生命年(DALY)是测量疾病负担最常用的指标,但使用DALY指标的疾病负担研究的报告质量参差不齐。为了规范此类疾病负担研究的报告,国际学者制订并于近期在Population Health Metrics期刊发布了STROBOD声明,其检查清单包括标题、摘要、引言、方法、结果、讨论和开放科学7个部分,共涉及28个条目。为了帮助国内学者更好地理解和应用该报告标准,本文结合已发表的实例对各条目进行了解读,以期提高相关疾病负担研究的整体质量,从而为公共卫生决策提供高质量的参考证据。展开更多
目的:通过对比青岛市城乡老年人健康查体资料分析城乡三高防治差异为诊疗提供资料。方法:整群抽样2023年青岛市城市社区497例老年人查体资料,采用倾向性匹配乡村社区497例老年人查体资料进行统计学对比分析。结果:共994人,年龄65~97 (80...目的:通过对比青岛市城乡老年人健康查体资料分析城乡三高防治差异为诊疗提供资料。方法:整群抽样2023年青岛市城市社区497例老年人查体资料,采用倾向性匹配乡村社区497例老年人查体资料进行统计学对比分析。结果:共994人,年龄65~97 (80.12 ± 5.05)岁,男性448人,约45%,女性546人,约55%,糖尿病患病率27.2%,糖尿病药物治疗率88.4%,空腹血糖控制达标率49.62%,二甲双胍药物治疗率70.0%,SGLT-2抑制剂治疗率10.5%,GLP-1RAS治疗率0%;城市社区糖尿病患者血糖控制达标率29.78%,药物治疗率81.6%,药物治疗后达标率52.6%,在患者人群中,双胍类治疗的使用率64.7%、SGLT-2抑制剂的使用率12.0%、GLP-1RAS的使用率0%;乡村社区糖尿病患者血糖控制达标率24.55%,药物治疗率99%,药物治疗后达标率37.5%,在患者人群中,双胍类的使用率76.9%、SGLT-2抑制剂的使用率8.7%、GLP-1RAS的使用率0%;城市肥胖率21.5%,乡村肥胖率21.3%。结论:1. 乡村糖尿病药物治疗率高于城市社区,青岛市社区老年人群心血管疾病危险因素管理存在城乡异质性,社区慢病管理在心血管疾病危险因素管理中发挥重要作用。2. 糖尿病管理可降低对人民健康和社会经济发展带来的不良影响。Objective: To provide information for different diagnosis and treatment by comparing the health checkup data of the elderly in urban and rural areas of Qingdao. Methods: A total of 497 elderly people’s health checkup data from urban communities in Qingdao in 2023 were selected by cluster sampling, and the data were statistically compared with those of 497 elderly people from rural communities after propensity score matching. Results: A total of 994 people were included, aged 65 to 97 (80.12 ± 5.05) years, with 448 males (about 45%) and 546 females (about 55%). The prevalence of diabetes was 27.2%, the rate of drug treatment for diabetes was 88.4%, the rate of achieving the target fasting blood glucose was 49.62%, the rate of metformin treatment was 70.0%, the rate of SGLT-2 inhibitor treatment was 10.5%, and the rate of GLP-1RAS treatment was 0%. The rate of achieving the target blood glucose in urban community diabetic patients was 29.78%, the rate of drug treatment was 81.6%, and the rate of achieving the target after drug treatment was 52.6%. Among the patients, the usage rate of biguanides was 64.7%, the usage rate of SGLT-2 inhibitors was 12.0%, and the usage rate of GLP-1RAS was 0%. The rate of achieving the target blood glucose in rural community diabetic patients was 24.55%, the rate of drug treatment was 99%, and the rate of achieving the target after drug treatment was 37.5%. Among the patients, the usage rate of biguanides was 76.9%, the usage rate of SGLT-2 inhibitors was 8.7%, and the usage rate of GLP-1RAS was 0%. The obesity rate in urban areas was 21.5%, and that in rural areas was 21.3%. Conclusion: 1. The rate of drug treatment for diabetes in rural areas is higher than that in urban communities. There are urban-rural differences in the management of cardiovascular disease risk factors among the elderly in Qingdao communities, and primary care plays an important role in the management of cardiovascular disease risk factors. 2. The management of diabetes can reduce the adverse impact on people’s health and social and economic development.展开更多
文摘目的分析2012—2023年重庆市老年人自杀死亡率与死亡疾病负担变化趋势,为开展有针对性的干预提供建议。方法利用重庆市2012—2023年死因监测数据中根本死因为自杀(《国际疾病与相关健康问题统计分类第10版》编码:X60~X84、Y87)的60岁及以上老年人死亡个案,分析死亡率、标化死亡率、早死寿命损失年(years of life lost,YLL)率、平均寿命损失年(average years of life lost,AYLL)及不同死因构成比,比较不同性别和地区死亡率,率的趋势变化采用年度变化百分比(annual percent of change,APC)和平均年度变化百分比(average annual percent of change,AAPC)进行分析。结果2012—2023年60岁及以上老年人自杀死亡率与标化死亡率总体呈下降的趋势,分别以年均3.54%与4.02%下降,变化趋势均有统计学意义(P<0.05)。2012—2016年自杀死亡率以年均4.53%上升,2016—2021年以年均8.91%下降,变化趋势均有统计学意义(P<0.05)。仅2020年与2022年男性自杀死亡率高于女性(P<0.05)。2012—2023年男性自杀死亡率与标化死亡率分别以年均2.86%和3.44%下降,女性分别以年均4.21%和4.69%下降,变化趋势均有统计学意义(P<0.05)。农村地区老年人历年自杀死亡率均高于城市地区,差异均有统计学意义(P<0.05)。2012—2023年城市地区老年人自杀死亡率与标化死亡率均保持相对平稳的水平(P>0.05),而农村地区老年人自杀死亡率与标化死亡率分别以年均3.44%与4.02%下降(P<0.05)。60岁及以上老年人自杀导致的YLL率与AYLL分别由2012年的3.03‰与18.54年下降至2023年的2.26‰与17.50年,AAPC分别为-4.02%与-0.60%,变化趋势均有统计学意义(P<0.05)。比较历年不同自杀方式构成发现,杀虫剂中毒死亡占比呈下降的趋势,而悬吊死亡、从高处跳下、淹溺占比均呈上升的趋势(P<0.05)。结论重庆市60岁及以上老年人自杀死亡率较高,疾病负担较重,总体呈下降的趋势,应重视老年人自杀的早期识别与干预。
文摘明确疾病负担对于确定卫生工作的重点及优化医疗资源的配置至关重要,但研究方法和假设的差异往往会影响疾病研究结果间的可比性,进而导致卫生决策困境。伤残调整生命年(DALY)是测量疾病负担最常用的指标,但使用DALY指标的疾病负担研究的报告质量参差不齐。为了规范此类疾病负担研究的报告,国际学者制订并于近期在Population Health Metrics期刊发布了STROBOD声明,其检查清单包括标题、摘要、引言、方法、结果、讨论和开放科学7个部分,共涉及28个条目。为了帮助国内学者更好地理解和应用该报告标准,本文结合已发表的实例对各条目进行了解读,以期提高相关疾病负担研究的整体质量,从而为公共卫生决策提供高质量的参考证据。
文摘目的:通过对比青岛市城乡老年人健康查体资料分析城乡三高防治差异为诊疗提供资料。方法:整群抽样2023年青岛市城市社区497例老年人查体资料,采用倾向性匹配乡村社区497例老年人查体资料进行统计学对比分析。结果:共994人,年龄65~97 (80.12 ± 5.05)岁,男性448人,约45%,女性546人,约55%,糖尿病患病率27.2%,糖尿病药物治疗率88.4%,空腹血糖控制达标率49.62%,二甲双胍药物治疗率70.0%,SGLT-2抑制剂治疗率10.5%,GLP-1RAS治疗率0%;城市社区糖尿病患者血糖控制达标率29.78%,药物治疗率81.6%,药物治疗后达标率52.6%,在患者人群中,双胍类治疗的使用率64.7%、SGLT-2抑制剂的使用率12.0%、GLP-1RAS的使用率0%;乡村社区糖尿病患者血糖控制达标率24.55%,药物治疗率99%,药物治疗后达标率37.5%,在患者人群中,双胍类的使用率76.9%、SGLT-2抑制剂的使用率8.7%、GLP-1RAS的使用率0%;城市肥胖率21.5%,乡村肥胖率21.3%。结论:1. 乡村糖尿病药物治疗率高于城市社区,青岛市社区老年人群心血管疾病危险因素管理存在城乡异质性,社区慢病管理在心血管疾病危险因素管理中发挥重要作用。2. 糖尿病管理可降低对人民健康和社会经济发展带来的不良影响。Objective: To provide information for different diagnosis and treatment by comparing the health checkup data of the elderly in urban and rural areas of Qingdao. Methods: A total of 497 elderly people’s health checkup data from urban communities in Qingdao in 2023 were selected by cluster sampling, and the data were statistically compared with those of 497 elderly people from rural communities after propensity score matching. Results: A total of 994 people were included, aged 65 to 97 (80.12 ± 5.05) years, with 448 males (about 45%) and 546 females (about 55%). The prevalence of diabetes was 27.2%, the rate of drug treatment for diabetes was 88.4%, the rate of achieving the target fasting blood glucose was 49.62%, the rate of metformin treatment was 70.0%, the rate of SGLT-2 inhibitor treatment was 10.5%, and the rate of GLP-1RAS treatment was 0%. The rate of achieving the target blood glucose in urban community diabetic patients was 29.78%, the rate of drug treatment was 81.6%, and the rate of achieving the target after drug treatment was 52.6%. Among the patients, the usage rate of biguanides was 64.7%, the usage rate of SGLT-2 inhibitors was 12.0%, and the usage rate of GLP-1RAS was 0%. The rate of achieving the target blood glucose in rural community diabetic patients was 24.55%, the rate of drug treatment was 99%, and the rate of achieving the target after drug treatment was 37.5%. Among the patients, the usage rate of biguanides was 76.9%, the usage rate of SGLT-2 inhibitors was 8.7%, and the usage rate of GLP-1RAS was 0%. The obesity rate in urban areas was 21.5%, and that in rural areas was 21.3%. Conclusion: 1. The rate of drug treatment for diabetes in rural areas is higher than that in urban communities. There are urban-rural differences in the management of cardiovascular disease risk factors among the elderly in Qingdao communities, and primary care plays an important role in the management of cardiovascular disease risk factors. 2. The management of diabetes can reduce the adverse impact on people’s health and social and economic development.
