基于倾向性评分匹配法的慢性病共病对我国老年人多维健康状况的影响研究

Research on Impact of Multiple Chronic Conditions on Multidimensional Health Status of Elderly People in China Based on Propensity Score Matching

目的:分析慢性病共病对我国老年人多维健康状况的影响,为改善老年人多维健康状况提供参考。方法:选取2021年中国综合社会调查数据库中60岁及以上老年人为研究对象。在描述我国老年人慢性病共病现状与多维健康状况的基础上,利用倾向性评分匹配法将有慢性病共病与无慢性病共病的老年人进行匹配,并进行单因素和多重线性回归分析,探究慢性病共病对老年人多维健康状况的影响。结果:1004例研究对象中,慢性病共病的发生率为30.3%,多维健康状况得分均值为(11.11±2.93),生理健康状况得分明显低于心理和社会健康状况。倾向性评分匹配后,共匹配到无慢性病共病和慢性病共病老年人300对,共600例。回归结果显示,慢性病共病是我国老年人多维健康状况的重要危险因素(β=-0.277,P<0.001)。此外,居住地、婚姻状况、饮酒史、睡眠质量、是否定期体检也是老年人多维健康状况的影响因素(P<0.05)。结论:我国老年人心理健康和社会健康状况优于生理健康状况,慢性病共病是老年人多维健康状况的重要危险因素。应进一步提升老年人多维健康状况认知水平,加快构建医防融合慢性病管理创新模式,培养老年人健康生活方式与行为,同时关注老年人心理健康,鼓励老年人社会参与。

Objective:To analyze the influence of multiple chronic conditions on the multidimensional health status of elderly people in China,so as to provide references for improving their multidimensional health status.Methods:The elderly(≥60 years old)from the Chinese general social survey in 2021 as the research subjects were selected.On the basis of describing the current status and multidimensional health status of chronic disease comorbidities among elderly people in China,the propensity score matching(PSM)was used to match individuals with and without multimorbidity.The association of multimorbidity with multidimensional health was analyzed by univariate and suffering from multiple linear regression analyses.Results:Among the 1004 cases,the prevalence of multimorbidity was 30.3%and the average score of multidimensional health status was(11.11±2.93),and the physical health status was significantly lower than the psychological and social health status.A total of 300 pairs(600 cases)of multimorbidity and non-multimorbidity were obtained after PSM.Multiple linear regression analysis showed that multimorbidity was the risk factor of multidimensional health status of elderly people in China(β=-0.277,P<0.001).In addition,place of residence,marital status,drinking history,sleep quality,and whether regular physical examinations were also influencing factors for the multidimensional health status of the elderly(P<0.05).Conclusion:The psychological and social health status of elderly people in China is superior to their physical health status,and suffering from multiple chronic conditions is an important risk factor for multidimensional health status in elderly people.We should further enhance the cognitive level of multidimensional health among the elderly,accelerate the construction of an innovative model for integrating medical prevention and chronic disease management,cultivate healthy lifestyles and behaviors for the elderly,and pay attention to their mental health and encouraging their social participation.