黑龙江省农村居民慢性病患病率及影响因素分析

Prevalence rate and influencing factors of chronic diseases among rural residents in Heilongjiang Province

目的探讨黑龙江省农村居民慢性病患病情况,并分析其影响因素,为开展农村地区慢性病防控提供建议。方法资料来源于第五次国家卫生服务调查,采用多阶段分层整群随机抽样的方法抽取黑龙江省农村居民4 801户,共13 498人,由经过培训合格的调查员对调查户的所有成员逐一进行询问并收集问卷,调查内容主要包括家庭成员人口社会经济学特征、家庭成员的医疗保障情况、居民慢性病患病情况等,运用SAS9.2软件对居民慢性病患病情况及影响因素进行统计分析。结果调查地区居民慢性病患病率按照人数和例数计算,分别为252.4‰和349.4‰,其中男性为312.9‰,女性为386.8‰。多因素分析结果显示,与年龄小于35岁相比,年龄35～<65岁(OR=7.604,95%CI=6.077～9.516,P=0.000)、年龄65岁及以上(OR=17.254,95%CI=13.195～22.563,P=0.000)是居民慢性病患病的危险因素,年龄越大慢性病患病率越高;与未婚相比,已婚(OR=1.884,95%CI=1.312～2.704,P=0.001)、离婚或丧偶(OR=2.246,95%CI=1.504～3.353,P=0.000)的慢性病患病率高;与文盲相比,文化程度(均OR<1,均P<0.05)越高,居民慢性病患病率越低;参加医疗保险的人群慢性病患病率高(OR=1.587,95%CI=1.060～2.376,P=0.025);距最近医疗机构的距离与小于1 km相比,大于5 km(OR=1.567,95%CI=1.103～2.227,P=0.012)患病率高;与人均住房面积小于20 m2相比,人均住房面积大于36 m2(OR=1.500,95%CI=1.295～1.737,P=0.000)慢性病患病率高;人均年收入(均OR<1,均P<0.05)越高,慢性病患病率越低;饮酒(OR=1.160,95%CI=1.042～1.986,P=0.030)慢性病患病率高。结论 2013年黑龙江省农村居民的慢性病患病率高,其中女性、老年人、离婚或丧偶、文化程度低、未参保和经济收入低的人群是卫生服务需求的重点人群。

Objective To explore the prevalence rate and influencing factors of chronic diseases among rural residents in Heilongjiang Province so as to provide suggestions for conducting chronic disease prevention and control in rural areas. Methods We collected the data from the Fifth National Health Service Survey. A stratified cluster random sampling method was used to select 13,498 rural residents from 4,801 households in Heilongjiang Province. All the family members of each household were interviewed face-to-face by the trained qualified investigators, and the contents of the questionnaire mainly included the family members ＇ social economic characteristics, medical insurance and the prevalence of chronic diseases in the residents. All the questionnaires were retrieved, and SAS9.2 software was employed for statistically analyzing the prevalence and influencing factors of chronic diseases. Results The prevalence rates of chronic diseases based on calculating the number of persons and the number of cases were 252.4‰ and 349.4‰ respectively, of which the prevalence rates of males and females were 312.9‰ and 386.8‰ respectively. Multi-factor analysis showed that compared with the age of less than 35 years, the age of 35-〈65 years （ OR=7.604, 95%CI： 6. 077-9.516, P=0.000） and the age of 65 years and above （OR= 17.254, 95%CI： 13.195-22.563, P=0.000） were the risk factors for suffering from chronic diseases. The older the age, the higher the prevalence rate of chronic diseases. Compared with the single, the married （OR= 1.884, 95%CI： 1.312-2.704, P= 0.001） and the divorced or widowed （ OR = 2.246, 95%CI： 1.504- 3. 353, P= 0.000） had higher prevalence rates of chronic diseases. Compared with the illiteracies, the higher the residents＇ educational level, the lower the prevalence rate of chronic diseases （ all OR〈 1, all P〈0.05）. The residents with medical insurance had a higher prevalence rate of chronic diseases （OR= 1.587, 95%CI： 1.060-2.376, P= 0.025）. Compared with the residents living less than 1 kilometer away from the nearest medical instituion, those hying more than 5 kilometers showed a higher prevalence rate awall （OR= 1. 567, 95% CI： 1. 103-2. 227, P = 0. 012）. Compared the residents with the per capita housing area less than 20 square meters, those with more than 36 square meters had a higher prevalence rate （ OR = 1.500, 95% CI： 1. 295- 1. 737, P = 0. 000）. The higher the per capita annual income, the lower the prevalence rate of chronic diseases （ all OR〈 1, all P〈0.05）. Drinking induced a higher prevalence rate of chronic diseases （OR= 1.160, 95%CI： 1.042-1.986, P= 0.030）. Conclusions The prevalence rate of chronic diseases in the rural residents in Heilongjiang Province is high. The females, the elderly, the divorced or widowed, residents with poor educational background, the uninsured and low-income residents are the key groups in great demand for health services.