我国居民基本医疗素养水平变化趋势分析

Analysis on the change trends of basic medical literacy level of Chinese residents

目的分析2012—2017年我国居民基本医疗素养水平的变化趋势与变化规律,发现素养提升中的关键环节。方法采取单纯随机抽样方法,在2012—2017年全国居民健康素养监测数据库中抽取足够样本,构建APC模型描述在扣除了人口学因素的影响后我国居民基本医疗素养水平的变化趋势。结果扣除了人口学因素的影响后,以2012年为对照组,2014、2015年基本医疗素养水平与对照组差异无统计学意义(P>0.05),2016年与2017年素养水平高于对照组(P<0.001);相邻两年间相比,除2015年外(P>0.05),之后几年均较前1年基本医疗素养水平有所增长(P<0.001)。年龄的OR=0.999(P>0.05),年龄^(2)的OR=0.999(P<0.01)。与1943—1947年出生者相比,1953—1957年、1958—1962年以及1963—1967年出生者基本医疗素养水平均较低(OR=0.742、0.617、0.563)。除城乡与是否患慢病外,其他人口学因素均对基本医疗素养水平有显著影响(P<0.001)。结论自2014年起,我国居民基本医疗素养水平大幅上升且增速加快。年龄效应微弱,在队列维度上,1953—1967年出生者比其他出生队列基本医疗素养水平低。人口学因素以及政策因素对基本医疗素养水平变化的影响不容忽视。

Objective To analyze the changing trends of basic medical literacy level of residents in China from 2012 to 2017,and to explore the key points of literacy improvement.Methods With the help of simple random sampling method,a sufficient number of samples were randomly selected from the national residents′health literacy monitoring database in 2012 to 2017 respectively.The APC models were constructed to describe the trends of basic medical literacy level over time after adjusting for demographic characteristics.Results After controlling for demographic characteristics,There was no significant difference between the basic medical literacy level in 2014 and 2015 and the control group(2012 as the control group,P>0.05)while the basic medical literacy levels in 2016 and 2017 were both higher than that of the control group(P<0.001).Comparing the adjacent two years,the basic medical literacy levels of all the other years increased compared with the previous year(P<0.001)except 2015(P>0.05).The OR value of age was 0.999(P>0.05),and the OR value of age^(2) was 0.999(P<0.01).Compared with those born in 1943-1947,the basic medical literacy levels of the births were all lower in 1953-1957,1958-1962,and 1963-1967(OR=0.742,0.617,0.563).Except for area(urban/rural)and NCD(suffering/not suffering),any other demographic variable had a significant effect on basic medical literacy levels(P<0.001).Conclusion Since 2014,the level of basic medical literacy of Chinese residents has shown a rapid growth trend.And the growth rate was accelerating.The age effect was weak,and the cohort effect indicated that those who were born in 1953-1967 had lower basic medical literacy level compared with other birth cohorts.The influence of demographic factors and policy factors on the changes in basic medical literacy level cannot be ignored.