经济发展和医疗保健可及性的差异在多大程度上解释了中国老年人各省之间的健康不平等？

Health Care Science Pub Date : 2023-03-09 DOI:10.1002/hcs2.32

Sol Richardson, Zhihui Li

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引用次数: 0

摘要

背景不均衡的经济发展导致了中国各省之间严重的健康不平等。省与省之间健康不平等的程度和潜在因素很少受到关注。方法采用中国健康与退休纵向研究（CHARLS）第二波（2013）中15278名受访者的数据，调查≥50岁人群的不平等状况在中国27个省级行政单位的5项健康结果中。在刻画了省际差异和省际效应的相关性之后，计算未调整和调整模型之间的方差比例变化，以确定由省级变量（包括经济发展和医疗保健可用性的衡量标准）解释的健康结果的省间方差的百分比。结果尽管省效应解释了<；占健康结果总体差异的10%，它们支撑了≥50岁人群之间的巨大省际不平等年。在解释健康结果，特别是抑郁症状和日常生活障碍的工具性活动的省与省之间差异时，人均地区生产总值比医生密度更重要。结论政策努力，包括更平等地分配医护人员，可能有助于减少省与省之间的健康不平等。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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To what extent do disparities in economic development and healthcare availability explain between-province health inequalities among older people in China?

Background

Uneven economic development has led to substantial health inequalities between Chinese provinces. The extent of, and factors underlying, between-province health inequalities have received little attention.

Methods

Data from 15,278 respondents in Wave 2 (2013) of the China Health and Retirement Longitudinal Study (CHARLS) were used to investigate inequalities among people aged ≥50 years in five health outcomes between 27 Chinese province-level administrative units. After characterizing the between-province differences and the relevance of province effects, proportional change in variance between unadjusted and adjusted models was calculated to determine the percentage of between-province variance in health outcomes explained by province-level variables including measures of economic development and healthcare availability.

Results

Although province effects explained <10% of overall variance in health outcomes, they underpinned large between-province inequalities among people aged ≥50 years. Gross Regional Product per capita was more important than doctor density in explaining between-province variance in health outcomes, particularly depression symptoms and instrumental activities of daily living impairment.