云南省彝族居民健康的公平性
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摘要
目的分析云南省彝族居民的健康状况及其公平性,为进一步改善云南省彝族居民健康水平提供依据。方法多阶段分层随机抽样抽取大理白族自治州、昭通市及普洱市3个州市的675名彝族居民,入户进行面对面的问卷调查。健康状况使用2周患病率、慢性病患病率和应住院率3个指标来反映,健康公平性采用集中指数(CI)及其分解进行分析。结果云南省彝族居民的2周患病率、慢性病患病率和应住院率分别为9.33%、13.93%和11.26%,3项指标均低于全国第5次卫生服务调查水平。随着年龄的增长,慢性病患病率及应住院率呈上升趋势(P<0.05)。2周患病、慢性病患病的水平不公平指数均为负值,呈倾贫性;应住院情况的水平不公平指数为正值,呈倾富性。结论云南省彝族居民健康状况总体尚可,但存在健康不公平。人均收入水平是影响健康公平性的最主要贡献因素;年龄、文化程度和婚姻状况是影响健康公平性的主要贡献因素。
Objective This study aimed to analyze the health status and health equity of Yi nationality residents, to provide references for improving health level of Yi nationality residents in Yunnan province. Methods 675 Yi nationality residents aged 16 or older were sampled by multi-stage stratified random sampling in Dali, Zhaotong and Puer. Investigators conducted face-to-face questionnaire survey in households. The prevalence rate of two weeks diseases, chronic diseases and required hospitalization were used to reflect the health status. The concentration index(CI) was used to analyze the health equity. Concentration index decomposition was used to analyze the contribution rate of influence factors. Results The prevalence rate of two weeks diseases,chronic diseases and the required hospitalizationwere 9.33%,13.93% and 11.26% respectively, lower than the results of the fifth health service survey in China. The rate of chronic diseases prevalence and required hospitalization were increased with age(P<0.05). The horizontal inequity indices of two weeks diseases and chronic diseases were negative,which showed the tendency of pro-poor inequity. The horizontal inequity index of required hospitalization were positive, which showed the tendency of pro-rich inequity. Conclusion The health status of Yi people in Yunnan Province was generally in good condition, but there was health inequity. The level of per capita income was a principal contributing factor to health inequity. Age, education and marital status were the main contributing factors to the inequity of health.
Objective This study aimed to analyze the health status and health equity of Yi nationality residents, to provide references for improving health level of Yi nationality residents in Yunnan province. Methods 675 Yi nationality residents aged 16 or older were sampled by multi-stage stratified random sampling in Dali, Zhaotong and Puer. Investigators conducted face-to-face questionnaire survey in households. The prevalence rate of two weeks diseases, chronic diseases and required hospitalization were used to reflect the health status. The concentration index(CI) was used to analyze the health equity. Concentration index decomposition was used to analyze the contribution rate of influence factors. Results The prevalence rate of two weeks diseases,chronic diseases and the required hospitalizationwere 9.33%,13.93% and 11.26% respectively, lower than the results of the fifth health service survey in China. The rate of chronic diseases prevalence and required hospitalization were increased with age(P<0.05). The horizontal inequity indices of two weeks diseases and chronic diseases were negative,which showed the tendency of pro-poor inequity. The horizontal inequity index of required hospitalization were positive, which showed the tendency of pro-rich inequity. Conclusion The health status of Yi people in Yunnan Province was generally in good condition, but there was health inequity. The level of per capita income was a principal contributing factor to health inequity. Age, education and marital status were the main contributing factors to the inequity of health.
引文
[1]云南省人民政府.彝族[EB/OL].(2012-12-03)http://www.yn.gov.cn/yn_lyyn/yn_ssz/201212/t20121203_8809.html.
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[6]戴萌.广东省部分城市中青年居民慢性病及卫生服务需求与利用现状的调查[D].广州:南方医科大学博士论文,2008.
[7]潘红潮.广西贫困县农村居民卫生服务需求与利用现状及其影响因素分析[D].南宁:广西医科大学硕士学位论文,2015.
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[12]李晓梅,罗家洪,何利平,等.宣威市新型农村合作医疗参合农民卫生服务利用公平性分析[J].中国医院统计,2008,15(4):289-292.
[13]王杰.云南省昭通市农村居民卫生服务利用公平性研究[D].昆明:昆明医科大学硕士学位论文,2016.
[14]何利平,李晓梅,孟琼,等.昆明市区盘龙区参合农民两周患病影响因素分析[J].昆明医学院学报,2009,30(4):1-3.
[15]赵江,闵向东,汤钦岚,等.云南省≥15岁怒族居民2016年慢性病患病及其影响因素[J].中国公共卫生,2018,34(8):1158-1162.
[16]刘茂玲,曾广富,邹宇华.贵州省农村卫生服务公平性研究[J].中国卫生经济,2008,26(10):49-50.
[17]何利平,喻箴,孟琼,等.昭通不同性别农村居民需住院影响因素分析[J].昆明医科大学学报,2017,38(9):39-43.
[18]张存辉.吉林省居民健康状况和卫生服务利用情况及影响因素分析[D].长春:吉林大学硕士学位论文,2011.
[19]李慧娟,徐凌忠,王兴洲.威海市城乡不同社会经济地位居民健康状况公平性研究[J].中国卫生事业管理,2008,25(11):776-779.
[20]王文华.河南省居民慢性病调查与失能调整期望寿命分析[D].郑州:郑州大学硕士学位论文,2006.
[21]伊雅德,谭红专,黄昕,等.湖南省浏阳市农村居民慢性病患病现状及影响因素分析[J].中华疾病控制杂志,2013,17(01):27-30.
[22]张连军,袁兆康,郑增旺,等.江西省农村地区老年人慢性病患病状况及其公平性调查[J].中国全科医学,2015,18(7):814-817.
[23]陈昭君.山东省城乡居民健康不平等及其分解研究[D].济南:山东大学硕士学位论文,2016.
[24]盘小梅.关于少数民族人口流动模式多样性的思考--基于对彝族、回族、撒拉族和壮族的调查[J].黑龙江民族丛刊,2014,29(03):1-6.
[2]何利平,李晓梅,吴騻,等.云南省彝族居民卫生服务利用公平性研究[J].卫生软科学,2017,31(4):21-24.
[3]徐玲,孟群.第五次国家卫生服务调查结果之二-卫生服务需要、需求和利用[J].中国卫生信息管理杂志,2014,10(3):193-194.
[4]毛立坡,刘国琴,任晓晖,等.贵州省苗族、仡佬族及汉族的健康状况和生命质量分析[J].现代预防医学,2007,34(4):701-703.
[5]童小云,丁宏,邹胜男,等.产业聚集区居民卫生服务需求与利用分析[J].中国农村卫生事业管理,2016,36(1):4-7.
[6]戴萌.广东省部分城市中青年居民慢性病及卫生服务需求与利用现状的调查[D].广州:南方医科大学博士论文,2008.
[7]潘红潮.广西贫困县农村居民卫生服务需求与利用现状及其影响因素分析[D].南宁:广西医科大学硕士学位论文,2015.
[8]李明,杨坤,董志新.卫生服务需要、需求与利用研究---以四川省为例[J].经济体制改革,2016,33(2):41-46.
[9]汪胜.深圳市公明街道社区卫生服务需求与利用研究[D].昆明:昆明医学院硕士学位论文,2007.
[10]孙晓梅.大理州农村居民卫生服务利用公平性研究[D].昆明:昆明医科大学硕士学位论文,2014.
[11]阎国钢.海南省五指山市黎族农村卫生服务网调查研究[D].太原:山西医科大学硕士学位论文,2006.
[12]李晓梅,罗家洪,何利平,等.宣威市新型农村合作医疗参合农民卫生服务利用公平性分析[J].中国医院统计,2008,15(4):289-292.
[13]王杰.云南省昭通市农村居民卫生服务利用公平性研究[D].昆明:昆明医科大学硕士学位论文,2016.
[14]何利平,李晓梅,孟琼,等.昆明市区盘龙区参合农民两周患病影响因素分析[J].昆明医学院学报,2009,30(4):1-3.
[15]赵江,闵向东,汤钦岚,等.云南省≥15岁怒族居民2016年慢性病患病及其影响因素[J].中国公共卫生,2018,34(8):1158-1162.
[16]刘茂玲,曾广富,邹宇华.贵州省农村卫生服务公平性研究[J].中国卫生经济,2008,26(10):49-50.
[17]何利平,喻箴,孟琼,等.昭通不同性别农村居民需住院影响因素分析[J].昆明医科大学学报,2017,38(9):39-43.
[18]张存辉.吉林省居民健康状况和卫生服务利用情况及影响因素分析[D].长春:吉林大学硕士学位论文,2011.
[19]李慧娟,徐凌忠,王兴洲.威海市城乡不同社会经济地位居民健康状况公平性研究[J].中国卫生事业管理,2008,25(11):776-779.
[20]王文华.河南省居民慢性病调查与失能调整期望寿命分析[D].郑州:郑州大学硕士学位论文,2006.
[21]伊雅德,谭红专,黄昕,等.湖南省浏阳市农村居民慢性病患病现状及影响因素分析[J].中华疾病控制杂志,2013,17(01):27-30.
[22]张连军,袁兆康,郑增旺,等.江西省农村地区老年人慢性病患病状况及其公平性调查[J].中国全科医学,2015,18(7):814-817.
[23]陈昭君.山东省城乡居民健康不平等及其分解研究[D].济南:山东大学硕士学位论文,2016.
[24]盘小梅.关于少数民族人口流动模式多样性的思考--基于对彝族、回族、撒拉族和壮族的调查[J].黑龙江民族丛刊,2014,29(03):1-6.