我国农村居民自评健康状况与报告行为实证研究

目的:对我国农村居民的自评健康以及自评健康报告行为进行测量,检验自评健康指标的可靠性与稳健性。方法:采用多阶段整群抽样法抽取了3省1 800户农户进行入户调查,共有5 849名农村居民纳入分析。使用世界价值观调查表中的自评健康状况问题,EQ-5D量表以及中国一般人群健康效用值积分体系,分别测量农村居民的自评健康状况和潜在健康状况,并利用两者的系统测量误差反映报告行为。采用卡方检验与方差分析检验不同特征农村居民的自评健康与报告行为的差异性。结果:农村地区女性、65岁及以上老年人群、小学及以下低学历水平、离退休、无业或失业、低收入水平、患有多种慢性病人群中,自评健康状况为"好"的比例相比其他人群更低,这部分农村居民的自评健康状况报告行为也更加悲观。结论:我国农村居民自评健康状况与报告行为变化趋势一致。自评健康指标在测量健康水平上具有较高的可靠性与稳健性。罹患合并症的慢性病患者是慢性病健康管理的重点人群。老年人群需要得到更多支持与关注。低收入水平对报告行为的负效应强于其他收入水平。健康行为与自评健康和报告行为的关系有待进一步挖掘。

An empirical study on self-rated health status and reporting behaviors of rural residents in China

Objective: This study was aimed to measure self-rated health (SRH) status and reporting behaviors of rural residents in China. The purpose was to increase the understanding of the reporting behavior and verify the reliability and robustness of SRH to measure health status. Methods: Health surveys were performed in 1,800 rural households from three provinces selected by the multi-stage cluster sampling, and a total of 5,849 rural residents were included for analysis. The SRH questions in World Values Survey, EQ-5D scale and the Chinese general population health utility value points system were used to measure SRH status and potential health of rural residents respectively. The systematic measurement error between SRH and potential health was measured to reflect the reporting behavior. Analysis of variance and Chi-square were used to test the significance of the differences between groups of rural residents for self-rated health and reporting behaviors. Results: In rural areas, female, retired or unemployed residents aged 65 and above, having primary or lower education level, in the lowest income levels and with multiple chronic diseases had lower percentage of good SRH status and were more pessimistic than other groups. Conclusions: The variation trend of SRH was consistent with that of reporting behavior. This indicates that SRH has strong reliability and robustness in the measurement of health status of rural residents in China. Patient groups suffering from multiple chronic diseases should be focused by the population health management. The elderly need more support and attention. The lowest income level exerts the strongest negative effect on reporting behavior than other income levels do. The relationship between health behaviors, SRH and reporting behaviors should be further excavated in future researches.