云南省牟定县202名农村老年人疾病经济负担及影响因素研究

Study on the economic burden of disease and its influencing factors in rural elderly

[目的]分析楚雄州牟定县高平村60岁以上农村老年人疾病经济负担状况及其影响因素,为制定农村老龄化应对策略提供科学依据。[方法]采用随机整群抽样方法抽取高平村的中村、王家村、牌坊村、吴家村4个自然村≥60岁农村居家老年人进行调查。[结果]202名被调查对象年总疾病经济负担为830,605.94元,其中直接经济负担797,629.00元,间接经济负担32,976.94元;家庭年平均经济负担为3999.75元,负担系数为0.26,老人负担系数为0.658。按0%、20%、40%、60%、80%的比例报销,支出型贫困发生率分别为22.28%、16.83%、10.40%、4.95%和0.99%。单因素分析显示,性别、年龄、慢性病患病状况、居住状况、住院状况、健康自评状况的老年人的疾病经济负担差异具有统计学意义(P<0.05)。[结论]高血压、骨关节疼痛、白内障严重影响了云南农村老人的生活质量;不同特征老年人疾病负担影响因素不一致,仍存在因病致贫风险,需要制度合力的保障;精准识别农村困难老人,多维度提高老人口疾病医疗保障水平。

Objective To analyze the economic burden of disease and its influencing factors among the elderly in Gaoping village,Mouding county,Chuxiong prefecture so as to provide scientific basis for formulating coping strategy for aging in rural area.Methods Random cluster sampling method was used to investigate the elderly people aged over 60 years old in Zhongcun,Wangjia,Paifang and Wujia four natural villages of Gaoping village.Results The total annual economic burden of 202 respondents was 830605.94 yuan,included 797629.00 yuan of direct economic burden and 32976.94 yuan of indirect economic burden;the average annual economic burden of family was 3999.75 yuan,and the burden coefficient was 0.126.The burden coefficient of the elderly was 0.658.According to reimbursement proportion of 0%,20%,40%,60%and 80%,poverty incidence of expenditure type was 22.28%,16.83%,10.40%,4.95%and 0.99%.Univariate analysis showed that there was statistical significance in economic burden differences of diseases among the elderly with gender,age,chronic disease status,living status,hospitalization status and self-rated health status(P<0.05).Conclusions Hypertension,cataract,bone and joint pain have a strong impact on the lift quality of rural elders in Yunnan Province.It is inconformity of influencing factors in different characteristic elders’disease burden.There is still risks of poverty caused by diseases,which need the guarantee of system together;accurately identify the elderly with difficulties in rural areas,and improve the medical insurance level of diseases for the elderly in multiple dimensions.