| 云南罗平县农村居民高血压患病和经济负担的变化趋势及社会经济差异分析 |
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| 引用本文： | 李锦波,范卢明,崔文龙,刘岚,莫怡,李国晖,蔡乐.云南罗平县农村居民高血压患病和经济负担的变化趋势及社会经济差异分析[J].现代预防医学,2022,0(22):4106-4111. |
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| 作者姓名： | 李锦波 范卢明 崔文龙 刘岚 莫怡 李国晖 蔡乐 |
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| 作者单位： | 昆明医科大学公共卫生学院，云南 昆明 650500 |
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| 摘 要： | 目的 分析云南省罗平县农村居民高血压患病和疾病经济负担的变化趋势及社会经济差异。方法 采用多阶段分层随机抽样方法在2011和2021年从罗平县分别抽取3 092和2 539名≥35岁常住居民进行问卷调查和体格检查，采用直接法测算高血压的直接经济负担，采用人力资本法测算间接经济负担，并采用主成分分析法构建个体社会经济地位得分。结果 从2011—2021年，罗平县农村居民高血压的患病率从20.1%上升到41.6%（χ2 = 306.314，P＜0.001），且不同性别、年龄段、文化程度、家庭人均年收入、医疗服务可及性和个体社会经济地位的村民其高血压患病率均呈上升趋势（均P＜0.05）；高血压患者的人均直接、间接和疾病经济负担分别从8 751.78、435.62和9 187.40元上升到13 631.97、462.02和14 093.99元，人均疾病经济负担占家庭人均年收入比从219.19%下降到100.26%，且2011和2021年高血压患者的人均直接疾病经济负担均以住院费用为主（分别占79.0%和72.9%）。2011年随着个体经济地位升高，高血压的患病率降低（χ2趋势= 15.410，P＜0.05）,而2021年未见明显趋势（P＞0.05）。2011年不同社会经济地位高血压患者间仅药费有统计学差异，且高社会经济地位患者的药费最高（F = 3.709，P = 0.019）；2021年不同经济地位高血压患者的各项费用均没有统计学差异（均P＞0.05）。结论 罗平县农村居民高血压的患病率和疾病经济负担均呈上升趋势，且存在社会经济差异。应针对不同特征人群采取相应的预防和控制措施降低高血压的发生，减轻其所造成的疾病经济负担。
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| 关 键 词： | 高血压 患病 经济负担 变化趋势 社会经济差异 农村居民 云南省 |
Analysis of socio-economic differences in the trend of hypertension prevalence and economic burden among rural residents in Luoping county,Yunnan Province |
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| LI Jin-bo,FAN Lu-ming,CUI Wen-long,LIU Lan,MO Yi,LI Guo-hui,CAI Le.Analysis of socio-economic differences in the trend of hypertension prevalence and economic burden among rural residents in Luoping county,Yunnan Province[J].Modern Preventive Medicine,2022,0(22):4106-4111. |
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| Authors: | LI Jin-bo FAN Lu-ming CUI Wen-long LIU Lan MO Yi LI Guo-hui CAI Le |
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| Affiliation: | School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China |
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| Abstract: | residents in Luoping county, Yunnan Province. Methods A total of 3 092 rural residents aged ≥35 years in 2011 and 2 539 in 2021 were selected by multi-stage stratified random sampling. Each participant received questionnaire survey and physical examination. Direct method was used to measure direct economic burden of hypertension, whereas human capital approach was applied to measure indirect economic burden. Principal component analysis was used to construct the individual socioeconomic comprehensive score. Results From 2011 to 2021, the prevalence of hypertension among the surveyed population increased from 20.1% to 41.6% (χ2=306.314, P<0.001), and this increasing rate was also observed among the subgroups categorized by sex, age, degree of education, income level, access to availability of medical institutions, and socioeconomic position (all P<0.05). The per capita direct, indirect, and total costs of hypertension increased from 8 751.78 yuan, 435.62 yuan, and 9 187.40 yuan to 13 631.97 yuan, 462.02 yuan, and 14 093.99 yuan, respectively. The ratio of per capita economic burden of disease to per capita annual household income dropped from 219.19% to 100.26%. The hospitalization expense was the main driver of per capita direct costs of hypertension both in 2011 and 2021 (79.0% and 72.9%, respectively). With the increasing of individual socioeconomic position, the prevalence of hypertension decreased in 2011 (χ2=15.410, P<0.05), while no significant trend was observed in 2021 (P>0.05). In 2011, there was only statistically significant difference in medication costs among the subgroup stratified by SEP, and individuals with highest socioeconomic position had the highest medication costs (F=3.709, P=0.019). However, there was no statistically significant difference in various categories of costs among the subgroup stratified by SEP in 2021 (all P<0.05). Conclusion An increasing trend of prevalence and economic burden of hypertension has been observed among rural residents in Luoping county, and socio-economic differences do exist. Specific effective measures should be taken to reduce the occurrence of hypertension, so as to reduce the disease economic burden. |
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| Keywords: | Hypertension Prevalence Economic burden Trend Socioeconomic difference Rural residents Yunnan Province |
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