社区老年慢性病共存患者治疗负担现状及影响因素研究  

Treatment Burden and Influencing Factors of Elderly Patients with Multimorbidity in the Community

作　　者：豆丽园 黄娟[2] 叶森 郭理想 DOU Liyuan;HUANG Juan;YE Sen;GUO Lixiang(School of Nursing and Health,Zhengzhou University,Zhengzhou 450000,China;People's Hospital of Zhengzhou,Zhengzhou 450003,China;The First Affiliated Hospital of Henan University of TCM,Zhengzhou 450000,China)

机构地区：[1]郑州大学护理与健康学院,河南省郑州市450000 [2]郑州人民医院,河南省郑州市450003 [3]河南中医药大学第一附属医院,河南省郑州市450000

出　　处：《中国全科医学》2021年第13期1671-1675,共5页Chinese General Practice

摘　　要：背景随着我国老龄化进程的增快,老年人口增多,老年慢性病共存患者增多,慢性病共存引起的治疗负担给患者带来诸多不利影响。目的了解我国社区老年慢性病共存患者治疗负担现状及影响因素。方法2019年9—12月采用便利抽样法选取郑州市两家社区卫生服务中心下属社区的370例老年慢性病共存患者为调查对象。运用一般资料调查问卷、慢性病共存治疗负担问卷进行调查。采用有序Logistic回归分析社区老年慢性病共存患者治疗负担的影响因素。结果回收有效问卷350份,有效回收率为94.6%。350例调查对象中,4例(1.1%)没有治疗负担,47例(13.4%)低度治疗负担,173例(49.4%)中度治疗负担,126例(36.0%)高度治疗负担。有序Logistic回归分析结果显示,家庭人均月收入、医保类型、慢性病数量、查尔森合并症指数(CCI)分级是社区老年慢性病共存患者治疗负担的影响因素(P<0.05)。结论社区老年慢性病共存患者治疗负担大部分处于中高度水平,治疗负担较重。应重点关注家庭收入低、慢性病数量多、CCI分级高、医保类型为新型农村合作医疗的老年慢性病共存患者,国家应加大医保报销比例、范围,医务人员应加强健康教育等针对性的干预措施,减轻老年慢性病共存患者的治疗负担。Background The treatment burden of growing multimorbidity prevalence in increasing elderly people against the backdrop of rapid aging in China,has produced many negative effects on these people.Objective To understand the treatment burden and influencing factors among elderly people with multimorbidity in the community.Methods From September to December 2019,by use of convenience sampling,370 elderly individuals with multimorbidity were selected from communities receiving the healthcare services delivered by two community health centers of Zhengzhou,and were invited to attend a survey using the General Information Questionnaire and the Chinese version of Multimorbidity Treatment Burden Questionnaire(MTBQ).Ordinal Logistic regression was used to identify the factors associated with treatment burden caused by multimorbidity.Results Altogether,350(94.6%)individuals who returned responsive questionnaires were included for analysis,among whom,the prevalence of no,low,moderate,and high treatment burden was 1.1%(4/350),13.4%(47/350),49.4%(173/350),and 36.0%(126/350),respectively.Ordered Logistic regression analysis revealed that monthly household income per capita,type of medical insurance,number of chronic diseases,and Charlson Comorbidity Index(CCI)were associated with treatment burden.Conclusion The treatment burden of most elderly patients with multimorbidity in the community was moderate-to-high.Attention should be paid to those with low household income per capita,multiple chronic diseases,high CCI,and/or new rural cooperative medical insurance.Moreover,to reduce the treatment burden of these patients,it is suggested to increase the proportion and scope of medical insurance reimbursement,and strengthen health education related to chronic diseases and targeted interventions delivered by medical workers.

关 键 词：社区卫生服务 慢性病共存 治疗负担 老年人 影响因素分析 

分 类 号：R197[医药卫生—卫生事业管理]