罗平县农村居民糖尿病的疾病经济风险及影响因素研究  

Disease economic risks and influencing factors of diabetes among rural residents in Luoping County of Yunnan Province

作　　者：保清柔 史睿敏 黎澳 何连菊 刘岚 李锦波 莫怡 蔡乐 BAO Qingrou;SHI Ruimin;LI Ao;HE Lianju;LIU Lan;LI Jinbo;MO Yi;CAI Le(School of Public Health,Kunming Medical University,Kunming,Yunnan 650500,China)

机构地区：[1]昆明医科大学公共卫生学院,云南昆明650500

出　　处：《中国农村卫生事业管理》2022年第10期743-748,共6页Chinese Rural Health Service Administration

基　　金：2021年国家级大学生创新性实验项目;昆明医科大学大学生创新性实验项目(2021JXD008);云南省创新团队培育计划项目(202005AE160002)。

摘　　要：目的了解云南省罗平县农村居民糖尿病疾病经济风险及相关影响因素。方法于2021年7月在云南省罗平县采用多阶段分层随机抽样方法抽取年龄≥35岁的998名村民进行面访调查及体检。结果云南省罗平县农村居民糖尿病的患病率为15.3%,且随着年龄增长呈现上升趋势(趋势χ^(2)=10.776,P=0.001)。患有肥胖(χ^(2)=4.749,P=0.029)、高血压(χ^(2)=5.732,P=0.017)以及有糖尿病家族史(χ^(2)=13.064,P<0.001)的农村居民糖尿病患病率均高于未患肥胖、高血压以及没有糖尿病家族史者。糖尿病患者的人均直接、间接和疾病经济负担分别为4763.46元、177.78元和4941.24元,其中,男性人均直接疾病经济负担高于女性(t=2.124,P=0.034);云南省罗平县农村糖尿病患者家庭灾难性卫生支出和因病致贫发生率分别为8.1%和2.7%;糖尿病患者所面临的疾病经济风险是调查人群的1.55倍(RR=1.55,ARR=1.58)。logistic回归分析结果显示,年龄越大的农村居民越容易发生家庭灾难性卫生支出(OR=1.070,95%CI=1.042~1.098)和因病致贫(OR=1.054,95%CI=1.010~1.099),人均年收入较低的农村居民(OR=0.266,95%CI=0.134~0.529)则更易出现家庭灾难性卫生支出。结论云南省罗平县农村居民糖尿病患病率及疾病经济风险较高,应重视当地糖尿病的干预和健康管理,增加对中老年及低收入家庭的财力支持和医疗援助。Objective To analyze the disease economic risks and influencing factors of diabetes among rural residents in Luoping County,Yunnan Province.Methods We used a multi-stage stratified random sampling method to select 998 rural residents aged≥35 years from Luoping County of Yunnan Province in July 2021 for face-to-face questionnaire interview and physical checkup.Results Among the study population,the overall prevalence of diabetes among rural residents was 15.3%,and the prevalence of diabetes increased with age(trendχ^(2)=10.776,P=0.001).Obese people(χ^(2)=4.749,P=0.029),hypertensive people(χ^(2)=5.732,P=0.017),and people with family history of diabetes(χ^(2)=13.064,P<0.001)had higher prevalence of diabetes than their counterparts.The per capita direct,indirect,and disease economic burdens of diabetes were4763.46 Yuan,177.78 Yuan,and 4941.24 Yuan,respectively,and were higher in males than females(t=2.124,P=0.034).The incidences of catastrophic medical payment and poverty due to illness were 8.1%and2.7%,respectively.The economic risk of diabetic patients was 1.55 times higher than that of the observed population(RR=1.55,adjusted RR=1.58).The result of Logistic regression analysis showed that people with older age were more likely to experience catastrophic medical payment(OR=1.070,95%CI=1.042~1.098)and poverty due to illness(OR=1.054,95%CI=1.010~1.099),whereas people with lower level of annual household income(OR=0.266,95%CI=0.134~0.529)were more likely to experience catastrophic medical payment.Conclusions The prevalence and economic risk of diabetes are relatively high among rural residents in Luoping County of Yunnan Province.It is important to enhance diabetes intervention and health management,as well as economic and medical support for older people and low-income families.

关 键 词：糖尿病 疾病经济风险 因病致贫 灾难性卫生支出 影响因素 农村 云南省 

分 类 号：R19[医药卫生—卫生事业管理] R587.1[医药卫生—公共卫生与预防医学]