中国全科医学2026，Vol.29Issue(7)：914-921,8.DOI:10.12114/j.issn.1007-9572.2024.0419
宁夏农村中老年人健康冲击的动态监测及影响因素研究:基于全面脱贫前后14年四期随访数据的实证研究
Dynamic Monitoring and Analysis of Influencing Factors of Health Shocks in Rural Middle Aged and Elderly People in Ningxia:Empirical Research Based on 14 Years and Four Periods of Follow-up Data before and after Poverty Alleviation
摘要
Abstract
Background With the continuous advancement of the aging process in our country,the health problems of the middle-aged and elderly population has increasingly become a social problem which cannot be overlooked.Objective To comprehensively understand the prevalence trend of health shock in rural middle-aged and elderly people in Ningxia during the 14 years before and after poverty alleviation,identify the dynamic changes of related influencing factors,and provide data support for effective identification and intervention of health shock.Methods This study selected the health follow-up data of four periods:the early stage of the new medical reform(2009),the promotion period of health poverty alleviation(2015),the poverty alleviation period(2019),and the transition period of rural revitalization and health poverty alleviation(2022).The research subjects were obtained by adopting the method of multi-stage stratified cluster random sampling.Firstly,all the towns and townships in the sample counties(Yanchi,Haiyuan,Pengyang,Xiji)were counted.The administrative villages of each town and township were divided into three levels according to the high,medium and low economic levels.40%of the natural villages were randomly selected from each level,and 33 rural households were selected from each village by the method of systematic sampling.The middle-aged and elderly people aged 45 and above in the household were taken as the research subjects and a questionnaire survey was conducted.The contents of the questionnaire survey include general demographic characteristics,indicators related to family economic status,health-related indicators,indicators related to the utilization of health services,and indicators related to health poverty alleviation policies.After excluding subjects with missing values for important variables,6 351,8 035,8 566,and 9 337 research subjects were included in the four phases of the survey,respectively.The prevalence trend changes in the incidence of health shocks were analyzed using the χ2 test.The single factors influencing the occurrence of health shocks were explored using the χ2 test or t-test.The fixed binary Logit regression model was used based on Grossman's theory of health needs to identify the effect magnitudes of the related influencing factors.Results In 2009,2015,2019 and 2022,the incidence of health shock in the rural elderly in Ningxia was 29.74%(1 889/6 351),27.18%(2 184/8 035),31.27%(2 679/8 566)and 25.00%(2 334/9 337).The difference was statistically significant(χ2trend=22.520,P<0.001),respectively.The regression results showed that before poverty alleviation,higher per capita annual income and larger family size were the main positive influencing factors of health shocks(P<0.001),while poor self-rated health status,debt due to illness and older age were the main negative influencing factors(P<0.001).After poverty alleviation,higher per capita annual income,larger family size and medical consultations within two weeks were the main positive influencing factors(P<0.001),while poor self-rated health status,debt due to illness and annual hospitalization were the main negative influencing factors(P<0.001).The impact of smoking on health was not significant(P>0.05).Conclusion In the 14 years before and after poverty alleviation,the incidence of health shock of the middle-aged and elderly people in rural Ningxia has decreased significantly.The main factors affecting the occurrence of health shock are higher per capita annual income,larger family size,medical consultations within two weeks and debt due to illness.It is necessary to increase the policy support of government funds,improve the level of residents'income,and improve the medical security system to reduce the incidence of health shocks among the middle-aged and elderly people in rural Ningxia.关键词
健康状况/健康冲击/Grossman健康需求理论/动态监测/影响因素分析/中老年人Key words
Health status/Health shocks/Grossman's theory of health needs/Dynamic monitoring/Root cause analysis/Middle-aged and elderly people分类
医药卫生引用本文复制引用
杨娟,刘姗,李飞,孟浩东,乔慧,谢永鑫..宁夏农村中老年人健康冲击的动态监测及影响因素研究:基于全面脱贫前后14年四期随访数据的实证研究[J].中国全科医学,2026,29(7):914-921,8.基金项目
国家自然科学基金资助项目(72264032,72164033) （72264032,72164033）
宁夏重点研发项目(引才专项)(2022BSB03082) （引才专项）
