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中老年人因超重和肥胖导致的自付医疗费用研究 预览

Out-of-pocket Care Expenditures Due to Excess of Body Weight in the Chinese Population Aged 45 and Older
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摘要 目的超重和肥胖为居民带来了巨大的经济负担,自付医疗费用是居民经济负担的重要组成部分,本文旨在探讨中老年人因超重和肥胖所导致的自付医疗费用。方法采用2013年'中国健康与养老追踪调查(China health and retirement longitudinal study,CHARLS)'数据库的数据,调查45岁及以上10908位居民的人口学特点,并通过二部模型探讨总人群BMI分层与自付医疗费用的关系及基本医保对于超重和肥胖人群自付医疗费用的影响。采用计量经济学的方法计算超重和肥胖自付医疗费用的归因比例。结果 2013年我国中老年人超重率和肥胖率分别为31.51%和12.98%。超重者和肥胖者的自付费用(2613.60元/年和2768.49元/年)高于正常体重者(1804.45元/年)。二部模型的结果表明,超重者和肥胖者分别比正常体重者多21.35%和49.43%的可能产生自付医疗费用;已产生的自付医疗费用中,超重者和肥胖者分别比正常体重者高10.34%和13.37%。2013年,中老年人归因于超重和肥胖自付医疗费用的比例分别为6.13%和5.18%。结论政府应采取有效措施降低超重和肥胖率,建议进一步改进医保制度,减轻中老年人超重和肥胖人群的经济负担。 Objective Overweight and obesity often lead to the increase of health care costs,and the out-of-pocket expenditures is the main part of residents’ economic burden.The study aims to analyze the out-of-pocket expenditures due to excess of body weight in the Chinese population aged 45 and older.Methods The Chinese Health and Retirement Longitudinal Study(CHARLS)Database 2013 with 10908 respondents aged 45 and older was used in the research.Two-part regression models were performed to investigate the association of BMI and the out-of-pocket expenditures and the association of basic health insurance and the out-of-pocket expenditures in overweight and obese people.The fraction of the national out-of-pocket expenditures attributable to overweight and obesity among Chinese population aged 45 and older was calculated using an econometric model.Results The proportions of overweight and obese residents were 31.51% and 12.98% respectively.Overweight and obese groups had significantly higher out-of-pocket care expenditures(RMB2613.60/year and RMB2768.49/year,respectively)as compared to the normal-weight group(RMB 1804.45/year).When controlled for demographic characteristics,overweight and obese adults aged 45 and older were 21.35% and 49.43% more likely to incur out-of-pocket expenditures,and in the restricted sample of those that incur expenditures,overweight and obese individuals had 10.34% and 13.37% higher out-of-pocket expenditures compared with normal-weight group.Overall,it was estimated that 6.13% out-of-pocket expenditures were attributable to obesity and 5.18% to overweight in the Chinese population aged 45 and older in 2013.Conclusion The policy makers should take effective action to reduce the prevalence of overweight and obesity and improve the medical insurance system to alleviate the economic burden of the overweight and the obesity aged 45 and older.
作者 闫晓芳 史静琤 程文炜 刘晓芳 Yan Xiaofang;Shi Jingcheng;Cheng Wenwei(Department of Epidemiology and Statistics,Xiangya School of Public Health,Central South University(410078),Changsha)
出处 《中国卫生统计》 CSCD 北大核心 2019年第1期22-27,共6页 Chinese Journal of Health Statistics
关键词 超重 肥胖 自付费用 二部模型 Overweight Obesity Out-of-pocket expenditures Two-part model
作者简介 通信作者:史静琤,E-mail:jingzhengs@126.com.
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