基于夏普利值分解法浙江省成年居民健康效用值影响因素分析  

Health utility value and its influencing factors among adult residents in Zhejiang province:a cross-sectional study using Shapley value decomposition analysis

作　　者：戴品远 周晓燕 王浩[1] 龚巍巍[1] 潘劲[1] 关云琦 钟节鸣[1] 李娜[1] DAI Pinyuan;ZHOU Xiaoyan;WANG Hao;GONG Weiwei;PAN Jin;GUAN Yunqi;ZHONG Jieming;LI Na(Institute of Chronic Non-communicable Disease Prevention and Control,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China)

机构地区：[1]浙江省疾病预防控制中心慢性非传染性疾病预防与控制所,杭州310051

出　　处：《中国公共卫生》2024年第7期823-828,共6页Chinese Journal of Public Health

基　　金：2023年度浙江省软科学研究计划项目(2023C35007);浙江省社科联资助项目(2022B64)。

摘　　要：目的了解浙江省成年居民的健康效用值及其影响因素,为制定和评价健康政策提供参考依据。方法于2022年9月—2023年2月采用多阶段随机抽样方法在浙江省抽取30个区/县共8684名成年居民进行问卷调查,应用复合层次有序概率(CHOPIT)模型校正并测算其健康效用值,并采用多元线性回归模型和夏普利值分解法分析浙江省成年居民健康效用值的影响因素及其贡献度。结果浙江省8684名成年居民的平均健康效用值为(0.703±0.158);夏普利值分解法分析结果显示,基本特征、经济社会地位、健康服务可及性、行为习惯和健康水平的夏普利值分别为0.277、0.106、0.042、0.067和0.024,对健康效应值的贡献度分别为53.67%、20.62%、8.16%、12.95%和4.60%;多元线性逐步回归模型分析结果显示,性别、年龄、文化程度、职业、家庭人均年收入、是否高血压和睡眠质量为浙江省成年居民健康效用值的主要影响因素,其夏普利值分别为0.006、0.114、0.188、0.029、0.229、0.020和0.052,对健康效应值的贡献度分别为0.98%、18.01%、29.09%、4.65%、35.84%、3.18%和8.25%,其中女性、年龄较高、文化程度较低、离退休人员、家庭人均年收入较低、高血压和睡眠质量较差会降低浙江省成年居民的健康效用值。结论浙江省成年居民健康自评总体情况较好,应加强对女性、中老年、文化水平较低和低收入群体以及患高血压和睡眠质量较差者健康状况的关注以进一步提高居民的健康相关生命质量。Objective To understand the health utility value and its influencing factors among adult residents in Zhejiang province,and to provide a reference for health policy formulation and evaluation.Methods A face-to-face survey using a self-developed questionnaire was conducted from September 2022 to February 2023 among 9000 adult residents(≥18 years)recruited using a multistage random sampling technique from 30 districts/counties in Zhejiang province.Participants'health utility values were calculated and adjusted using the compound hierarchical ordered probit model(CHOPIT).Multiple linear regression model and Shapley value decomposition method were used to analyze the effects and contributions of influencing factors on participants'health utility values.Results The mean health utility value was 0.703±0.158 for 8684 successfully surveyed participants.The Shapley value decomposition analysis showed that the Shapley value was 0.277 for demographic characteristics,0.106 for socioeconomic status,0.042 for accessibility of health services,0.067 for behavioral habits,and 0.024 for health status,with attributable contributions of 53.67%,20.62%,8.16%,12.95%,and 4.60%to the health utility value,respectively.The multiple linear stepwise regression model analysis showed that gender,age,education level,occupation,annual household income per capita,hypertension,and sleep quality were the main factors influencing the health utility value of the adult residents,with Shapley values/attributed contributions of 0.006/0.98%,0.114/18.01%,0.188/29.09%,0.029/4.65%,0.229/35.84%,0.020/3.18%,and 0.052/8.25%,respectively,and being female,older age,lower education level,being retired,lower annual household income per capita,hypertension,and poor sleep quality were correlated with reduced health utility value of adult residents.Conclusion The overall self-rated health of adult residents in Zhejiang province is relatively good.Attention should be paid to the health status of adult residents who are female,middle-aged and elderly,with low educat

关 键 词：健康效用值 影响因素 夏普利值分解法 成年居民 

分 类 号：R195[医药卫生—卫生统计学]