慢性病患者健康贫困脆弱性的影响因素研究

Study on the Influencing Factors of Health and Poverty Vulnerability of Patients with Chronic Diseases

目的:通过健康贫困脆弱性的研究识别慢性病患者中的高脆弱性群体及其影响因素,为健康反贫困政策的调整与施行提供借鉴。方法:以2016年全国家庭追踪调查数据为基础,从慢性病患者个人特征、健康水平、卫生服务、医疗保障、疾病预防与控制5个维度出发,选取与其相关的21个评价指标对慢性病患者的健康贫困脆弱性进行综合评价,并通过tobit回归找出影响慢性病患者健康贫困脆弱性的关键因素。结果:慢性病患者个人特征中,城乡、年龄、性别和受教育年限是健康贫困脆弱性的影响因素;慢性病患者健康水平中,健康状态、两周不适、BMI指数和睡眠质量是健康贫困脆弱性的影响因素;慢性病患者医疗服务中,医疗总花费、看病点满意度、对医生的信任度、看病地点和看病点医疗水平是健康贫困脆弱性的影响因素;慢性病患者医疗保障中,医疗保险是健康贫困脆弱性的影响因素;慢性病患者疾病预防与控制中,吸烟和喝酒是健康贫困脆弱性的影响因素。结论:做好脆弱性评估工作,精准识别脆弱性较高的慢性病患者;构建多元参与的共治网络,建立健康贫困脆弱性预警体系;完善慢性病患者医疗服务及医疗保障体系。

Objective: To identify the high vulnerable groups and their influencing factors in patients with chronic diseases through the study of health poverty vulnerability, so as to provide references for the adjustment and implementation of health anti-poverty policy. Methods: Based on the 2016 National Family Tracking Survey data, it selected 21 evaluation indicators to evaluate the health poverty vulnerability of patients with chronic diseases from five dimensions: personal characteristics, health level, health service, medical security, disease prevention and control. Tobit regression was used to identify key factors of the health poverty vulnerability affecting patients with chronic diseases. Results: Among the individual characteristics of patients with chronic diseases, urban and rural areas, age, gender and years of education were the influencing factors of vulnerability to health poverty in patients with chronic diseases;among the health status of chronic patients, health status, two-week discomfort, BMI index and sleep quality were the influencing factors of vulnerability to health poverty in patients with chronic diseases;among the medical services for patients with chronic diseases, total medical expenses, satisfaction with medical treatment, trust in doctors, medical treatment sites and medical treatment at the medical treatment points were the influencing factors of vulnerability to health poverty in patients with chronic diseases;among the medical security for patients with chronic diseases, medical insurance is the influencing factors of vulnerability to health poverty in patients with chronic diseases;among the disease prevention and control in patients with chronic diseases, smoking and drinking were the influencing factors of vulnerability to health poverty in patients with chronic diseases. Conclusion: It should do a good job in vulnerability assessment, accurately identify chronic patients with high vulnerability, build a multi-participatory cogovernance network, establish a health poverty vulnerability early warning system and improve the medical service and medical security system for chronic patients.