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健康促进视角下中老年慢性病患者贫困脆弱性影响因素研究

Influencing factors for the vulnerability to poverty in middle-aged and elderly patients with chronic diseases: from the perspective of health promotion

作者:

邵芯苗 郭庆 吴忠

单位:

上海,上海工程技术大学管理学院

关键词:

中老年慢性病患者;贫困脆弱性;健康促进

分类号:

R197

DOI:

10.3969/j.issn.2095-7432.2022.01.002

出版年,卷(期),页码:2022,12 (1):7-12

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摘要:

目的 提高中老年慢性病患者健康水平和防贫就医能力,降低中老年慢性病患者的贫困脆弱性。方法 基于 2018 年 中国健康与养老追踪调查的中老年慢性病患者数据,选取个人特征、健康水平、医疗条件及医疗保障、疾病预防 4 个维度的 23 个变量,通过 Probit 模型分析健康风险下中老年慢性病患者的贫困脆弱性。结果 就患者的个人特征而言,女性、年龄较大、婚 姻不稳定、处于退休状态是贫困脆弱性的影响因素;慢性病患者健康水平中,自评健康、患慢性病数量、情绪低落、孤独和睡 眠质量是贫困脆弱性的影响因素;医疗支出和医疗保障中,医疗支出、城镇职工医疗保险、城镇居民医疗保险、新型农村合作 医疗保险、城乡居民医疗保险和补充医疗保险是贫困脆弱性的影响因素;疾病预防变量中,吸烟和喝酒是贫困脆弱性的影响因 素。结论 患者个人良好的心身健康状况对降低贫困脆弱性会产生积极的影响;各类医疗保险是防范中老年慢性病人群因病致 贫、返贫的有效手段,中老年慢性病患者应积极参加各类社会保险,有效降低慢性病导致的返贫风险。

英文摘要:

Objective To improve the health level and poverty prevention among middle-aged and elderly patients with chronic diseases and to reduce their vulnerability to poverty (VTP). Methods Data were obtained from the middle-aged and elderly patients with chronic diseases in the 2018 China Health and Aging Tracking Survey. Twenty-three items in four dimensions (i.e. demographic characteristics, health status, health care and medical coverage, and disease prevention) were selected for analyzing the VTP in this population using a Probit model. Results In terms of demographic characteristics, female gender, advanced age, unhappy marriage, and retirement were risk factors for VTP. In terms of health status, low self-rated health status, multiple chronic diseases, low mood, loneliness, and poor sleep quality were contributors to VTP. In terms of health care cost and medical insurance coverage, medical expenditures, urban workers' medical insurance, urban residents' medical insurance, new rural cooperative medical insurance, andurban and rural residents' medical insurance and supplementary medical insurance were influential factors for VTP. In terms of diseaseprevention variable, smoking and alcohol consumptions were influential factors for VTP. Conclusion Good mental and physical health has a positive role in reducing VTP. Various types of medical insurance are effective means to prevent poverty caused by illness among middle-aged and elderly people with chronic diseases, and this population should be encouraged to actively participate in social insurance, so as to effectively reduce the risk of returning to poverty due to chronic diseases.

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