基于Fairlie分解法的中国老年人慢性病共病状况城乡差异研究  

The urban-rural disparity in chronic comorbidities prevalence among elderly population based on Fairlie decomposition method

作　　者：李敏莹 亢玉婷 陶睿嘉 张鹏俊[2] 王辰[3,4] Li Minying;Kang Yuting;Tao Ruijia;Zhang pengjun;Wang Chen(School of Management,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Scientific Research,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;National Center for Respiratory Medicine,China State Key Laboratory of Respiratory Health and Multimorbidity,China-Japan Friendship Hospital/National Center for Respiratory Medicine/Institute of Respiratory Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学管理学院,北京100029 [2]北京医院科研处、国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [3]中国医学科学院北京协和医学院,北京100730 [4]国家呼吸医学中心呼吸和共病全国重点实验室中日友好医院呼吸与危重症医学科,北京100029

出　　处：《中华老年医学杂志》2024年第12期1616-1622,共7页Chinese Journal of Geriatrics

摘　　要：目的分析我国城乡老年人慢性病共病状况之间存在的差异,为制定城乡特异性老年人健康管理和卫生政策提供科学依据。方法基于2020年中国健康与养老追踪调查(CHARLS)调查数据中的9252例60岁及以上老年人为研究对象,用Logistic回归分析法和Fairlie分解法,分析城乡老年人慢性病共病分布差异及其相关因素的贡献率。结果在9252例老年人中,慢性病共病患病率为66.10%;城镇老年人共病患病率高于农村老年人(68.52%比64.86%),且差异具有统计学意义(χ2=12.421,P<0.001);Logistic回归分析结果显示:睡眠在6 h以上、有就业、健康自评为健康的城镇老年人慢性病共病患病率较低,65岁及以上城镇老年人共病患病率较高;睡眠在6 h以上、有就业、个人年收入在10000元及以上、健康自评为健康、生活满意度较高的农村老年人慢性病共病患病率较低。Fairlie分解结果显示,老年人就业情况和睡眠时间对扩大老年人慢性病共病之间的城乡差异有统计学意义(P<0.05),贡献率分别为69.22%和6.92%。结论在全球老龄化背景下,本研究探讨了城乡老年人共病患病率影响因素,研究结果提示改善老年人睡眠情况,促进老年人就业参与、社区活动及家庭互动等有利于缩短城乡健康差距,推动实现健康老龄化。ObjectiveTo analyze the disparity in the prevalence of chronic comorbidities between the urban and rural elderly populations,providing scientific evidence to tailor health management strategies and policies.MethodsData from 9,252 participants aged 60 years and older,drawn from the 2020 China Health and Retirement Longitudinal Study(CHARLS,2020),were analyzed.The urban-rural disparity in chronic comorbidities prevalence and the associated factors were examined using logistic regression analysis and Fairlie decomposition.ResultsOf the 9,252 participants,the rate of chronic comorbidities was 66.10%,with a higher prevalence observed in the urban population compared to the rural population(68.52%vs.64.86%,=12.421,P<0.001).Logistic regression analysis indicated that among the urban population,chronic comorbidities were less prevalent in participants who reported more than 6 hours of sleep,were employed,and assessed their health as good.Conversely,a higher prevalence was noted in individuals aged 65 and older.In the rural population,the rate of chronic comorbidities was lower in participants who reported more than 6 hours of sleep,were employed,had annual incomes exceeding RMB 10,000,assessed their health as good,and reported higher life satisfaction.Utilizing the Fairlie decomposition method,it was found that the differences in the prevalence of chronic comorbidities between urban and rural elderly populations were primarily attributable to employment status and sleep duration(P<0.05),with contribution rates of 69.22%and 6.92%,respectively.ConclusionsIn the context of global aging,this study examined the factors influencing the prevalence of comorbidity among elderly populations in urban and rural settings.The findings demonstrate that enhancing sleep quality,promoting employment opportunities,fostering community engagement,and encouraging family interaction may contribute to reducing the health disparities between urban and rural areas,thereby supporting healthy aging.

关 键 词：慢性病 共病现象 城乡差异 老年人 

分 类 号：R592[医药卫生—老年医学]