精准帮扶视域下灾难性卫生支出的脆弱群体分析*

目的：识别脆弱群体，降低灾难性卫生支出发生风险。方法：采用2018年《中国健康与养老追踪调查》数据。 用卡方检验比较不同组别之间灾难性卫生支出发生率，用logistic回归分析识别灾难性卫生支出的影响因素。结果：2018年， 家庭灾难性卫生支出总体的发生率为27.37%。logistic回归分析结果显示，已婚、自评健康差、家庭规模小、家庭经济情况差、有家庭成员利用门诊或住院卫生服务、家庭有慢性病患者、家庭有60岁以上成员的家庭为灾难性卫生支出的脆弱群体。 结论：鉴于灾难性卫生支出发生率较高，需采用更加精准有效的策略来降低居民的灾难性卫生支出发生风险。

Analysis of Vulnerable Groups of Catastrophic Health Expenditure from the Perspective of Precision Assistance

Objective: Recognizing vulnerable groups of catastrophic health expenditure and reducing the risk of catastrophic health expenditure. Methods: Data were drawn from the 2018 wave of China Health and Retirement Longitudinal Study. Chi square test was used to compare the incidence of catastrophic health expenditure between different groups. Logistic regression analysis was used to determine the influencing factors of catastrophic health expenditure. Results: The incidence of catastrophic health expenditure of families included in this study was 27.37% in 2018. Logistic regression model showed that married, poor self-rated health, small household size, poor household economic situation, household with member used outpatient or inpatient health services, household with member with chronic diseases and household with member over 60 years old were vulnerable groups of the occurrence of catastrophic health expenditure. Conclusion: Given the high incidence of catastrophic health expenditure, more precise and effective strategies are needed to reduce the risk of catastrophic health expenditure.