| 引用本文: |
李锦璇, 李玲.老年人慢性病共病模式对医疗负担的影响研究[J].湖南中医药大学学报,2026,46(1):190-199[点击复制] |
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| 老年人慢性病共病模式对医疗负担的影响研究 |
| 李锦璇,李玲 |
| (湖南中医药大学人文与管理学院, 湖南 长沙 410208) |
| 摘要: |
| 目的 探析老年人慢性病共病模式对医疗负担的影响，为制定更科学的老年健康干预措施提供决策依据。方法 基于中国健康与养老追踪调查2020年数据，筛选年龄在60岁及以上的老年慢性病患者作为研究对象，采用潜在类别分析识别其共病模式，并运用回归分析方法探讨不同共病模式对患者医疗负担的影响及潜在作用机制。结果 共纳入7 837名老年受试者，人均罹患慢性病2.29种，总体共病率达76.50%，可划分为低共病率组、呼吸系统疾病组、心血管代谢疾病组、胃病关节炎疾病组、高发共病组五类。以低共病率组为参照，其他类别组的老年人医疗负担显著增加，具体表现为门诊就诊率和住院率显著升高，医疗负担最为突出的为高发共病组，其次为呼吸系统疾病组。年龄、性别、居住地、年收入水平及医疗保险类型等因素总体上都与医疗负担相关，但其影响程度在不同共病模式下存在差异。结论 老年人慢性病共病模式是导致医疗负担加重的重要风险因素，应加强慢性病共病防控，重点关注老年人群中慢性病共病患病率高、医疗负担重的共病组合（如高发共病组、呼吸系统疾病组等），并依据其疾病特征和资源需求，合理配置医疗资源。 |
| 关键词: 老年人慢性病 老年健康 共病模式 共病率 医疗负担 |
| DOI：10.3969/j.issn.1674-070X.2026.01.028 |
| 投稿时间：2025-09-08 |
| 基金项目:湖南省哲学社会科学基金课题项目（21JD022）；湖南中医药大学研究生创新课题项目（2024CX0189）。 |
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| Impacts of chronic disease comorbidity patterns on healthcare burden in the elderly |
| LI Jinxuan, LI Ling |
| (School of Humanities and Management, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To explore the impact of chronic disease comorbidity patterns on healthcare burden in the elderly, and to provide decision-making basis for formulating more scientific health intervention measures for the elderly. Methods Based on the data of 2020 China Health and Retirement Longitudinal Study, elderly patients with chronic diseases aged 60 and above were selected as the study subjects. Latent class analysis was employed to identify their comorbidity patterns, and regression analysis was used to investigate the impact of different comorbidity patterns on patients' healthcare burden and potential underlying mechanisms. Results A total of 7 837 elderly subjects were included, with an average of 2.29 chronic diseases per person and the overall comorbidity rate was 76.50%. The subjects were divided into five groups: low comorbidity rate group, respiratory disease group, cardiovascular and metabolic disease group, gastric and arthritis disease group and high-prevelance comorbidity group. Compared with the low comorbidity rate group, the healthcare burden of the elderly in other groups increased significantly, characterized by notably higher outpatient visit rate and hospitalization rate. The high comorbidity group exhibited the most prominent healthcare burden, followed by the respiratory disease group. Factors such as age, gender, place of residence, annual income level and type of healthcare insurance were generally related to healthcare burden, but the degree of influence varied under different comorbidity patterns. Conclusion Chronic disease comorbidity patterns in the elderly are important risk factors leading to the increase of healthcare burden. It is essential to strengthen the prevention and control of chronic disease comorbidity, focusing on comorbidity combinations with high prevalence rates and heavy healthcare burdens among the elderly population (e.g., the high-prevalence comorbidity group and respiratory disease group). Healthcare resources should be allocated rationally based on their disease characteristics and resource needs. |
| Key words: chronic diseases in the elderly elderly health comorbidity patterns comorbidity rate healthcare burden |
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