四川省城乡老年人口慢性病患病现状及影响因素分析

目的 了解“新医改”10年后四川省城乡老年人口慢性病患病现状及其影响因素，为决策者合理配置卫生资源、提高老年人口健康水平提供科学依据。方法 采用多阶段分层整群随机抽样方法，随机抽取调查四川省14个市(州)常住人口21 047名，选取60岁以上老年人口6 647人纳入分析，采用两水平logistic回归分析慢性病患病影响因素。结果 四川省老年人口慢性病患病率为64.9%，其中城市65.2%，农村64.6%。患病率居于前5位的疾病是高血压(30.43%)、慢性阻塞性肺病(9.18%)、糖尿病(8.91%)、椎间盘疾病(7.04%)、脑血管病(6.21%)。同时患1、2、≥3种慢性病患病率分别是35.5%、18.0%、11.5%。多因素分析显示，性别(城:OR = 1.315,P = 0.001;乡:OR = 1.319,P = 0.001)、年龄(城:OR = 1.629,P＜0.001;乡:OR = 1.327,P = 0.002)、教育程度(乡:OR = 1.458,P＜0.001;OR = 1.567,P＜0.001)、职业状况(城:OR = 1.335,P = 0.002;乡:OR = 1.328,P = 0.001)、社会活动(城:OR = 0.754,P = 0.005)、失能情况(城:OR = 3.353,P＜0.001;乡:OR = 2.226,P＜0.001)、家庭医生签约(城:OR = 0.682,P＜0.001;OR = 0.703,P = 0.007)、经济状况(城:OR = 1.597,P＜0.001;乡:OR = 1.943,P＜0.001)、BMI指数(城:OR = 1.592,P＜0.001;乡:OR = 1.602,P＜0.001)是慢性病患病的影响因素。结论 四川省城乡老年人口慢性病患病率较高，建议政府积极应对人口老龄化，因地制宜开展老年人口健康保障措施，为居民提供更优质、公平、有效的卫生服务。

Analysis of prevalence and influencing factors of chronic diseases among the elderly in Sichuan Province

Abstract: Objective The study aimed to understand the current situation and influencing factors of prevalence of chronic diseases among the elderly in Sichuan Province 10 years after the "new medical reform" , so as to provide scientific basis for decision makers to rationally allocate health resources and improve the health level of the elderly population. Methods Amulti-stage stratified cluster random sampling method was used to investigate 21047 permanent residents in Sichuan Province and 6647 people over 60 years old were selected. Multilevel logistic models were used to explore the influencing factors of chronic illness. Results The prevalence of chronic diseases among the elderly in Sichuan Province was 64.9%, 65.2% of which were in urban areas and 64.6% in rural areas. The top five diseases were hypertension (30.43%), chronic obstructive pulmonary disease (9.18%), diabetes (8.91%), intervertebral disc disease (7.04%), cerebrovascular disease (6.21%). The prevalences of one, two and more than three chronic diseases were 35.5%, 18.0% and 11.5% respectively. Multivariate analysis showed that gender(city: OR=1.315, P<0.001; rural: OR=1.319, P<0.001), age (city: OR=1.629, P<0.001; rural: OR=1.327, P=0.002), education level(city: OR=1.458, P<0.001; rural: OR=1.567, P<0.001), occupational status (city: OR=1.335, P=0.002; rural: OR=1.328, P=0.001), social activities (city: OR=0.754, P=0.005), disability (city: OR=3.353, P<0.001; rural: OR=2.226, P<0.001), family doctor signing (city: OR=0.682, P<0.001; rural: OR=0.703, P=0.007), economic status (city: OR=1.597, P<0.001; rural: OR=1.943, P<0.007), BMI index (city: OR=1.592, P<0.001; rural: OR=1.602, P<0.001) were the influencing factors of chronic disease. Conclusion The prevalence of chronic diseases among the elderly in urban and rural areas in Sichuan Province is high. The government should actively respond to the aging of the population, carry out the aging health protection measures according to local conditions, and provide better quality, fair and effective health services for residents.