我国中老年慢性病患者疾病经济风险研究——基于社会-人群-家庭层面  

Study on Disease Economic Risk of Middle-Aged and Aged Chronic Disease Patients in China——Based on the Social-Population-Family Level

作　　者：李月 杨霞 许静怡 党媛媛 杨晓花 汤榕 LI Yue;YANG Xia;XU Jingyi;DANG Yuanyuan;YANG Xiaohua;TANG Rong(School of Public Health and Management,Ningxia Medical University,Yinchuan Ningxia 750004,China)

机构地区：[1]宁夏医科大学公共卫生与管理学院,宁夏银川750004 [2]宁夏自治区卫生健康委员会信息中心,宁夏银川750000

出　　处：《卫生经济研究》2023年第2期10-13,17,共5页

基　　金：宁夏自然科学基金项目“慢性病居民疾病经济负担和经济风险度影响效力机制研究”(2022AAC03212);宁夏科技厅健康管理科普项目(2021BSB03005)。

摘　　要：目的:分析我国中老年慢性病患者的疾病经济风险,帮助政策制定者精准定位靶向目标。方法:利用2018年中国健康与养老追踪调查数据,以直接医疗费用、疾病相对风险度、家庭灾难性卫生支出为指标,衡量慢性病给社会、人群、家庭带来的经济风险。结果:2018年我国中老年慢性病患者的门诊总费用4792.48万元,住院总费用3 559.02万元,自我医疗总费用1 998.62万元;在15%、25%、40%的界定标准下,中老年慢性病患者家庭灾难性卫生支出的发生率分别为52.07%、44.97%、36.86%。结论:社会层面,门诊医疗和自我医疗给中老年慢性病患者带来的经济负担高于住院医疗;人群层面,女性、60~89岁、参加城乡居民医保和无医保的患者以及恶性肿瘤患者面临的疾病经济风险更高,承受经济风险的能力更弱;家庭层面,慢性病加剧了家庭发生灾难性卫生支出的严重程度,农村和低保慢性病家庭更易发生灾难性卫生支出。Objective To analyze the economic risks of middle-aged and aged patients in China and help set policy targets. Methods Using the data of 2018 wave of China Health and Retirement Longitudinal Study, we employed direct medical costs, relative risk of disease,and household catastrophic health expenditure as indicators to measure the economic risks of chronic diseases to society, population and families. Results In 2018, the total outpatient cost, inpatient costs, and out-of-pocket money of middle-aged and aged patients with chronic diseases was 47.9248 million yuan, 35.5902 million yuan, and 19.9862 million yuan, respectively. Under the definition criteria of 15%,25% and 40%, the incidence of family catastrophic health expenditure was 52.07%, 44.97% and 36.86%, respectively. Conclusion At the social level, outpatient treatment and self-treatment bring higher economic burden to chronic patients than inpatient treatment. At the population level, those who are female, aged between 60 and 89, insured residents and uninsured patients, and with malignant tumors, report less ability of shoulder economic risk. At the family level, chronic diseases exacerbate the severity of catastrophic health expenditure in households. People living in rural areas and accepting basic living allowances are more prone to catastrophic health expenditure.

关 键 词：中老年 慢性病 相对风险度 灾难性卫生支出 疾病经济风险 

分 类 号：R197[医药卫生—卫生事业管理]