山西省低收入水平家庭疾病经济风险及影响因素研究

Disease economic risk and its influencing factors in low-income families in Shanxi Province

目的关注和分担弱势群体疾病经济风险,分析低收入家庭卫生疾病经济风险力度、强度及影响因素。方法采用全国第6次卫生服务统计数据,按照国际组织识别低收入群体的推荐标准,将研究对象划分为不同收入水平群体,以农村低收入群体和城市低收入群体为重点研究对象,采用logistic、Tobit模型对不同收入水平下家庭的灾难性卫生支出发生率、发生强度进行分析。结果对于农村低收入群体来说,被访者的健康自评水平、是否患有慢性病、近12个月是否体检、家庭人口数、收入水平是其灾难性支出发生与否的危险因素;对于城市低收入群体而言,被访者的健康自评水平、是否参加社会医疗保险、是否参加大病保险是其灾难性支付发生与否的危险因素。结论家庭规模对家庭疾病经济风险的作用方向取决于收入层次;低收入群体的个体健康状况更差,社会医疗保险显著降低了城市低收入群体的疾病经济风险,但慢性病给农村家庭带来了较大的疾病经济风险。

Objective To analyze the intensity and influencing factors of disease economic risks in low-income families.Methods Based on the data obtained from the Sixth National Health Service Survey and according to the recommended standards of international organizations in identifying low-income groups,we divided our subjects into different income groups.Focusing on rural and urban low-income groups,we used the logit and tobit models to analyze the incidence and intensity of catastrophic health expenditure of families at different income levels.Results For the rural low-income group,the respondents’self-rated health level,chronic disease,physical examination in recent 12 months,number of family members,and income level were the risk factors for the catastrophic health expenditure.For the urban low-income group,the self-rated health level,coverage of social medical insurance,and coverage of major disease medical insurance were the risk factors of catastrophic payment.Conclusions The impact of household size on the disease economic risk depends on income level.Individuals in the low-income groups have worse health conditions.Social medical insurance significantly reduces the disease economic risk in urban low-income group,whereas chronic diseases bring greater disease economic risk to rural families.