我国丧偶老人共病模式与灾难性卫生支出的关系研究  

Associations between comorbidity patterns and catastrophic health expenditures among widowed older adults in China

作　　者：王振 曾智[1,2] WANG Zhen;ZENG Zhi(School of Public Health and Health,Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]湖北医药学院公共卫生与健康学院,湖北十堰442000 [2]湖北医药学院卫生管理与卫生事业发展研究中心

出　　处：《现代预防医学》2023年第22期4136-4142,共7页Modern Preventive Medicine

基　　金：湖北省高校人文社科重点研究基地开放基金项目(2022ZDO02);教育部人文社会科学研究基金项目(17YJCZH015)。

摘　　要：目的了解我国丧偶老人慢性病共病模式与灾难性卫生支出之间的关系,为缓解丧偶老人疾病经济负担提供依据。方法基于2018年《中国健康与养老追踪调查》横截面数据,通过潜在类别分析识别丧偶老人慢性病共病模式,采用卡方检验进行不同组别间共病模式的差异性比较,使用logistic回归分析不同共病模式对灾难性卫生支出的影响。结果潜在类别分析确定5种共病模式:多系统疾病组、心血管疾病组、关节炎或风湿病组、较少慢性病组和慢性肺病组。丧偶老人家庭灾难性卫生支出发生率为32.34%。与较少慢性病组相比,其他4组均为丧偶老人家庭发生灾难性卫生支出(OR=2.666,95%CI:1.709~4.159;OR=2.375,95%CI:1.773~3.182;OR=1.569,95%CI:1.057~2.329;OR=1.663,95%CI:1.209~2.288)的危险因素。另外,年龄、区域位置、医保类型、工作情况以及家户人数也是丧偶老人家庭发生灾难性卫生支出的风险因素。结论丧偶老人家庭灾难性卫生支出发生率较高,共病模式是其重要风险因素,应加强慢性病防治,完善相关政策及制度,提高丧偶老人家庭抵御灾难性卫生支出风险能力。Objective To understand the relationship between multimorbidity patterns of chronic diseases and catastrophic health expenditure in widowed older adults in China,and to provide a basis for alleviating the economic burden of diseases in widowed older adults.Methods The study was based on the cross-sectional data of the China Health and Retirement Longitudinal Study 2018.Latent class analysis was used to identify the multimorbidity patterns of widowed older adults.Chi-square test was used to compare the differences in multimorbidity patterns among different groups,and logistic regression was used to analyze the impact of different multimorbidity patterns on catastrophic health expenditure.Results Latent class analysis identified five comorbidity patterns:multisystem disease group,cardiovascular disease group,arthritis or rheumatism group,less chronic disease group,and chronic lung disease group.The incidence of catastrophic health expenditure in widowed older adult family was 32.34%.Compared with the less chronic diseases group,the other four groups are all risk factors for catastrophic health expenditure in families of widowed elderly people(OR=2.666,95%CI:1.709-4.159;OR=2.375,95%CI:1.773-3.182;OR=1.569,95%CI:1.057-2.329;OR=1.663,95%CI:1.209-2.288).In addition,age,regional location,medical insurance type,work status,and household size were also significant risk factors for catastrophic health expenditure in widowed older adult families.Conclusion The incidence of catastrophic health expenditure in widowed older adult families is high,and the multimorbidity pattern is an important risk factor.It is necessary to strengthen the prevention and treatment of chronic diseases,improve the relevant policies and systems,and to improve the ability of widowed older adult families to resist the risk of catastrophic health expenditure.

关 键 词：丧偶老人 慢性病 共病 灾难性卫生支出 

分 类 号：R195.1[医药卫生—卫生统计学]