慢性病共病对灾难性卫生支出影响的实证研究  

An empirical study on the impact of chronic disease comorbidity on catastrophic health expenditure

作　　者：张倩雯 罗金萍 孙嘉颖 王康 尹文强[1] 陈钟鸣[1] 马东平 ZHANG Qianwen;LUO Jinping;SUN Jiaying;WANG Kang;YIN Wenqiang;CHEN Zhongming;MA Dongping(School of Management,Weifang Medical University,"Health Shandong"Severe Social Risk Prevention and Management Collaborative Innovation Center,Collaborative Innovation Center of Social Risks Gover-nance in Health,Weifang,Shandong 261053,China;不详)

机构地区：[1]潍坊医学院管理学院“健康山东”重大社会风险预测与治理协同创新中心、健康风险预警治理协同创新中心,山东潍坊261053 [2]潍坊市人民医院财务部

出　　处：《中国预防医学杂志》2024年第3期324-329,共6页Chinese Preventive Medicine

基　　金：国家自然科学基金资助项目(72004164)。

摘　　要：目的 探讨慢性病共病对灾难性卫生支出(catastrophic health expenditure,CHE)风险的影响,为降低CHE发生的可能性提供参考依据。方法 采用多阶段分层随机抽样原则抽取山东省居民进行问卷调查,问卷内容包括调查对象基本情况、慢性病共病、医疗卫生支出以及上一年家庭总收入等情况。基于倾向性得分匹配法,以Stata 16.0软件为工具分析慢性病共病CHE。结果 共调查居民489名,婚姻状况和养老保险情况是影响居民慢性病共病状况的重要因素;慢性病共病对CHE影响的平均处理效应分别为0.153、0.176、0.179,慢性病共病会使居民发生CHE的概率增加15.3%~17.9%(P<0.05)。患有慢性病共病且自评健康状况为不健康者发生CHE的概率提升15.1%~16.6%(P<0.05)。结论 慢性病共病增加了CHE发生的概率,患有慢性病共病会使自评不健康的居民发生CHE的概率大于健康的居民。应采取针对性的措施减轻慢性病共病带来的经济负担,降低CHE发生的风险。Objective To explore the impact of chronic disease comorbidity on the risk of catastrophic health expenditure and provide a reference for reducing the likelihood of catastrophic health expenditure.Methods Select residents in Shandong Province by using the principle of multi-stage stratified random sampling,including the basic information of the respondents,chronic diseases comorbidity,medical health expenditure,and the total household income of the previous year.Based on the propensity score matching(PSM),Stata 16.0 software was used as a tool to analysis catastrophic health expenditure of chronic disease comorbidity.Results A total of 489 residents were surveyed,and marital status and pension insurance status were found to be important factors influencing the comorbidity of chronic diseases among residents.The average treatment effects of chronic disease comorbidity on catastrophic health expenditure were 0.153,0.176 and 0.179,indicating that chronic disease comorbidity increases the probability of catastrophic health expenditure by 15.3%-17.9%(P<0.05).The probability of catastrophic health expenditure increased by 15.1%-16.6%(P<0.05)in patients with chronic disease comorbidity and self-rated unhealthy status.Conclusions Chronic disease comorbidity increases the likelihood of catastrophic health expenditure,with chronic disease comorbidity increasing the likelihood of catastrophic health expenditure for those who assess themselves as unhealthy than those who are healthy.Therefore,targeted measures should be taken to reduce the economic burden of chronic disease comorbidity and the risk of catastrophic health expenditure.

关 键 词：倾向性得分匹配法 慢性病共病 灾难性卫生支出 

分 类 号：R197[医药卫生—卫生事业管理]