多水平模型在居民慢病患病的影响因素分析中的应用

Analysis on the influencing factors of the Prevalence of Chronic Disease by Multilevel Mode

目的了解我国城乡居民的慢病现状及影响因素,为探索慢病预防控制的规划和政策提供依据。方法选取我国东、中、西部22个省(市、自治区)内合计35个县(区)的调查数据,分析居民慢病患病情况,并运用二项Logistic回归和多水平回归的统计方法,分析慢病的影响因素。结果共调查城乡居民7073人,男3868人,占54.7%;女3205人,占45.3%;城乡居民慢病患病率为22.7%。多水平模型显示,个体水平因素中,年龄较小(OR=1.049)、文化程度较高(OR值分别为0.886、1.039、0.676)、BMI较低(OR=1.036)、具备健康素养(OR=0.666)、无烟草暴露(OR=1.277)、无运动行为(OR=1.292)是慢病患病的保护因素,区域水平中,基层卫生机构数较多(OR值分别为1.649、2.006、1.893)和区域经济水平较高(OR值分别为1.727、1.272、0.838)是慢病患病的危险因素。结论我国居民慢性病患病率较高,不能单独依赖卫生系统对居民的个体干预,更需要一个综合社会经济和个体两个层面的行动框架来全面促进居民的健康。

Objective To study the prevalence of chronic disease and its behavior risk factors and provide scientific evidence for exploring the planning and policy to prevention and control chronic disease. Methods Our sample involved in 22 provinces across China were 35 districts. The study used logistic analysis and multi-level analysis to analyze main influencing factors of chronic disease. Results A total of 7073 survey of urban and rural residents were involved ; 3868 male, accounting for 54. 7%, 3205 female, accounting for 45. 3%. The prevalence of chronic disease was 22. 7%. Multi-level Model showed that the positive individual level factors were younger person （ OR = 1. 049 ） , higher education level （ OR = 0. 886, 1. 039, 0. 676）, lower BMI （ OR = 1. 036）, higher health literacy （ OR = 0. 666）, no tobacco exposure （ OR = 1. 277 ） and no exercising （ OR = l. 292）, and the passive regional level factors were the number of basic medical insurance （ OR = 1. 649, 2. 006, 1. 893） and the economic status （OR = 1. 727, 1. 272, 0. 838）. Conclusion The prevalence of chronic disease is high. We should not rely solely on individual interventions. What we need is a comprehensive framework for action at two levels of socio-economic and individual to promote the health of residents.