中国城乡老年人生活自理能力影响因素差异研究  

Differences in influencing factors for self-care ability between urban and rural elderly in China

作　　者：邵芯苗 吴忠 SHAO Xinmiao;WU Zhong(School of Management,Shanghai University of Engineering and Technology,Shanghai 201600,China;School of Management,Shanghai University of International Business and Economics,Shanghai 201620,China)

机构地区：[1]上海工程技术大学管理学院,上海201600 [2]上海对外经贸大学管理学院,上海201620

出　　处：《中国农村卫生事业管理》2022年第6期418-426,共9页Chinese Rural Health Service Administration

基　　金：国家社会科学基金项目(16BJY001);上海市人民政府决策咨询研究重点课题(2021-A-023)。

摘　　要：目的分析我国城乡老年人生活自理能力影响因素差异。方法基于城乡差异视角,运用决策树CART模型和Logistic回归,使用2018年中国健康与养老追踪调查数据,选取人口学特征、健康状况、社会参与、生活方式与健康行为因素和社会保障5个维度15个变量进行分析,并用受试者工作曲线(ROC)评价两种预测模型的效果。结果我国城乡老年人生活自理能力差异明显,相较于城镇老人,农村老人生活自理能力较差。2个影响因素模型分类预测效果的ROC曲线显示logistic回归结果效果更好(AUC=0.808/0.762,95%CI=0.780~0.836/0.745~0.780)。对比城乡影响因素,既有年龄、性别、慢性病、抑郁、参与社会经济活动、参与社会交往活动、照顾孙子女、喝酒等共性因素,也有个性因素。其中,教育程度、婚姻状况、户口类型、医疗保险和养老保险只对农村老年人生活自理能力有显著影响。结论在对高龄、有慢性病、未进行社会参与的老年人群体进行健康干预的基础上,国家还要促进卫生资源合理配置,实现城镇和农村老年人健康平等。Objective To analyze the differences in influencing factors for self-care ability between urban and rural elderly in China.Methods Based on the perspective of urban-rural differences,using the decision tree CART model and logistic regression,we used the data of 2018 China Health and Elderly Care Follow-up Survey to select and analyze 15 variables from five dimensions including demographic characteristics,health status,social participation,lifestyle and healthy behavior factors and social security,and then use receiver operating characteristic(ROC)curve to evaluate the effects of the two predictive models.Results There were significant differences in self-care ability between urban and rural elderly in China.Compared with urban elderly,rural elderly had poorer self-care ability.The ROC curve for the classification prediction effects of the two influencing factor models showed that the results of logistic regression was better(AUC=0.808/0.762,95%CI=0.780~0.836/0.745~0.780).There were not only common influencing factors such as age,gender,chronic diseases,depression,participation in socio-economic activities,participation in social activities,taking care of grandchildren,drinking and so on,but also individual influencing factors.Among these influencing factors educational background,marital status,household registration type,medical insurance and old-age insurance only had a significant impact on the self-care ability of rural elderly population.Conclusions On the basis of health intervention for the elderly with advanced age,chronic diseases and no social participation,the state should promote the rational allocation of health resources so as to realize health equality among the elderly population in urban and rural areas.

关 键 词：城乡老年人 生活自理能力 二元LOGISTIC模型 CART模型 

分 类 号：R197[医药卫生—卫生事业管理] R171.7[医药卫生—公共卫生与预防医学]