【作者】 周王艳；

【导师】 陈家应；

【作者基本信息】 南京医科大学 ， 社会医学与卫生事业管理， 2011， 硕士

【摘要】 研究目的:评价我国农村居民的健康相关生命质量与健康公平性,探索农村居民健康相关生命质量的潜在影响因素。研究方法:采用欧洲五维度健康量表(EQ-5D)对我国农村居民的健康状况进行测量。用VAS评分作为健康状况指标,用伪洛伦兹曲线和伪基尼系数评价不同家庭经济收入人群健康公平性。研究结果:①总人群:单因素分析中显示女性健康状况低于男性;随着年龄的增长,健康状况迅速恶化;丧偶人群的健康状况更差;受教育程度越高,健康状况相对越好;无业或失业人群的健康状况较差;有社保人群较比无社保人群健康状况更差;低收入人群面临更多健康问题;东、中、西部地区居民健康状况存在明显的地区差异;疼痛/不适和焦虑/抑郁两维度存在问题较多。多元线性回归F值为1844,P值为0.000,方程有统计学意义。对40个县农村居民自评健康得分(VAS)造成影响的因素中,有统计学意义的变量为性别、年龄、婚姻状况、就业状况、文化程度、收入五阶层、是否两周患病、有无慢病、是否住院。②农村已婚育龄妇女:已婚育龄妇女的总体健康状况好于一般人群,妇科疾病是妇女的主要健康问题,在婚、受教育程度高且无慢性妇科病的已婚育龄妇女生命质量较高。③农村老年人群:农村地区老年人总体生命质量明显低于一般人群,配偶健在、有亲友同住、家庭收入水平较好情况下,均有较好的生命质量,低龄老人健康优于70岁以上高龄老人。有慢性病的老年人生命质量较差。政策建议:①在卫生政策制定时,要关注农村居民的主要健康问题,重点保护妇女、老人、无业/失业、较低文化程度,低收入、有两周患病、有慢性病、有住院情况的人群,提高其健康公平性;②要关注农村已婚育龄妇女的健康问题,增强其自我健康意识、调整好来自家庭与工作的压力,定期开展妇女病的普查工作,加大对女性受教育问题的重视,采取相应的政策措施,以提高妇女的生命质量;③农村老年人健康问题较多,生命质量的提高需要家庭、政府、社会等多方的共同努力,尤其要关注高龄老人、独居及丧偶老人的身心健康。政府部门除了要加大对低收入老年人的医疗和生活救助外,还要重视老年保健服务,最大限度地提高老年人群的生命质量。更多还原

【Abstract】 Objectives: To evaluate the health-related quality of life (HRQoL) and health equality of rural people in China and analyze potential health-related influence factors.Methods: The health states of rural residents were measured by the scale of EQ-5D. And use VAS scoring as the health state indicator as well as use pseudo Lorenz curve and pseudo coefficient to evaluate the health equality of people with different incomes.Results:①General population:Single factor analysis show that women’s health was worse than that of men; with the aging,health rapidly deteriorates; widowed people have poorer health; people with higher education get more health benefits; unemployed people have poorer health states; people who have social security are in poor health than those who have not; low-income people meet more health-related problems; obviously, people’s health in east, middle and west China are different; more people had problems at the dimensions of“Pain/Discomfort”and“Anxiety/Depression”. Multiple Linear Regression :F value is 1844,P value is 0.000,the equation is statistically significant.Gender,age,marital status,employment,education,five class of income,whether the rural resident have two-week prevalence,chronic disease prevalence and annual hospitalization rates have statistical significance,they can influence the rural resident’s VAS of 40 counties.②Married women of childbearing age: the overall health state of married women of childbearing age was better than the others of general population. Gynecological diseases became the women’s main health problem. HRQoL of those women with higher level education and without gynecological diseases was better than others.③Elderly people: The overall HRQoL of the elderly in rural areas was significantly lower than that of the general population. The elderly people with spouse, family members living together or better economy states might have better health. The elderly people under 70 years old had higher HRQoL than who was over 70 years. The elderly with chronic diseases had worse health.Policy recommendations:①Health policy-making should be given more attention to rural resident’s main health problems. Groups such as women, the elderly,the jobless,low-education people,low-income people,people who have two-week prevalence,chronic disease,annual hospitalization should be protected as priority so as to improve equity in health.②We should pay more attention to the health problems of married women in childbearing age. Married women in childbearing age should increase their awareness of health and well deal with the pressure from family and work. The Government should carry out the census and treatment on women’s diseases periodically and pay more attention to women’s education. Relevant policies should be made to improve women’s health.③Elderly people have more health problems. To improve the elderly people, HRQoL need joint efforts from families, governments and society. Particularly we should focus on those groups such as the old-old people (over 70 years), solitary people and widowed elderly people. Apart from medical and living assistance to low-income elderly people, governments should pay attention to elderly people’s health care to increase their HRQoL.更多还原