宁夏海原县农村老年人健康公平性及其分解分析

Analyzing the Health Equity and its Decomposition of Rural Elderly in Haiyuan County of Ningxia

目的评价海原县农村老年人自评健康公平性,并分析各影响因素的贡献。方法利用家庭健康询问调查数据,采用集中指数及其分解法分析老年人自评健康公平性及各因素的贡献率。结果不同收入组老年人自评健康存在差异(P<0.01),基线和随访调查的集中指数分别为-0.0280和-0.0118,均存在亲富人的健康不平等。各因素对健康不平等的贡献中,基线调查,收入的贡献率为81.58%,就医距离≤1公里为24.45%,文盲为11.10%;随访调查,收入的贡献率为69.97%,就医距离1~2公里为69.03%,文盲为47.96%。结论新农合方案的调整使得健康不公平性有所改善但依然存在,收入对自评健康不平等的贡献仍最大,就医距离和文化水平的贡献有所突出。

Objective To analyze the inequity of self-assessment health(SAH),and quantify the contributions of determinats.in rural areas of Haiyuan County and the contribution rate of various factors to health inequality.Methods Data taken from the rural household health survey,concentration index(CI) and decomposition were applied to evaluate the inequity in SAH of the elderly and the contributions of each determinat.Results SAH was significant(P<0.01) among the elderly across different income groups.The CI of baseline and follow-up survey was-0.0280 and-0.0118,both have the pro-rich health inequality.Among the factors contributing to health inequality of SAH,in the baseline survey,the contribution rate of income was 81.58%,the distance from medical treatment ≤ 1 km for 24.45 m,illiteracy for 11.10 km.Follow-up investigation shows that the contribution rate of income was 69.97%,and the medical treatment distance was 1~ 2 km for 69.03%,and illiterate for 47.96%.Conclusion The adjustment of China’s New Rural Cooperative Medical Program has improved health inequality but not significantly.Income still had the highest contribution to the inequality of SAH.And the contribution of medical distance and cultural level has become prominent.