不同收入老年人健康状况公平性分析

Equity in health status among the elderly with different income

目的了解江苏省苏州市不同收入老年人健康状况差异性,为今后卫生机构改革和卫生资源配置提供参考依据。方法采用分层整群随机抽样方法对在苏州市抽取的8个社区共4 635名老年居民进行问卷调查。结果苏州市老年人的慢性病患病率和日常生活活动能力(ADL)受限率分别为78.1%和8.8%;慢性病患病率和ADL受限率的集中指数(CI)分别为0.043(男性0.035,女性0.061)和0.194(男性0.137,女性0.216);月平均收入<500、500～999、1 000～1 999、和≥2 000元老年人慢性病患病率分别为71.2%、73.3%、80.4%和84.2%,ADL受限率分别为14.3%、7.7%、7.5%和5.7%,不同收入老年人慢性病患病率、ADL受限率间差异均有统计学意义(P<0.001);居于慢性病患病率前5位的疾病依次为高血压(51.3%)、糖尿病(14.2%)、心脏病(11.2%)、关节炎(11.1%)和高血脂(8.3%);CI值最高的疾病为高血脂(0.411),最低的疾病为高血压(0.032);老年人患1、2和≥3种慢性病的比例分别为44.9%、21.7%和7.8%,其CI值分别为-0.071、0.130和0.218。结论苏州市不同收入老年人健康状况存在不公平性。

Objective To investigate the equity in health status among the elderly with different econonic condition and to provide the basis for the reform of health sectors and the allocation of health resources. Methods A questionnaire survey was conducted among 4 635 residents aged ≥60 years selected with multi-stage stratified random cluster sampling from 8 communities in Suzhou city, Jiangsu province. Results The prevalences of chronic diseases and activities of daily living （ADL） limitation were 78. 1% and 8.8% among the elderly and the concentration index（CI） of the two prevalences ware 0. 043（0. 035 for male,0. 061 for female） and - 0. 194 （ - 0. 137 for male, - 0. 216 for female）. For the elderly with different income levels of 〈 500,500 - 999,1 000 - 1 999, and I〉2 000 RMB Yuan per month, the prevalences of chronic diseases were 71.2% ,73.3% ,80. 4% ,and 84. 2% and the prevalences of ADL limitation were 14. 3% ,7.7% ,7. 5% ,and 5.7 %, respectively, with significant differences （P 〈 0. 001 for all）. The top five chronic diseases were high blood pressure （51.3%） ,diabetes（14. 2% ） ,heart disease（11.2% ） ,arthritis（11.1% ） ,and high cholesterol（8. 3% ） ,with the highest CI for high cholesterol （0. 411 ）and the lowest C1 for high blood pressure （0. 032）. The proportions of the elderly with 1,2, and ≥3 chronic diseases was 44. 9% ,21.7%, and 7.8%, with the CI values of - 0. 056,0. 128, and 0. 214, respectively. Conclusion Inequality exists in the health status among the elderly with different income in Suzhow city. Key words： health status; the elderly; different income; equality; concentration index （CI）