本文關(guān)鍵詞： 慢性病 肥胖癥 患病代價 農(nóng)村衛(wèi)生 云南　出處：《中國全科醫(yī)學(xué)》2017年07期 　論文類型：期刊論文

【摘要】：目的了解云南省農(nóng)村居民4種常見慢性病(高血壓、糖尿病、冠心病、腦卒中)的經(jīng)濟負擔(dān),并測算其歸因于肥胖的疾病經(jīng)濟負擔(dān)。方法于2015年1—9月采用多階段分層抽樣法,在云南省抽取12個行政村的5 040例居民,以完成問卷調(diào)查的4 979例為研究對象。采用自行設(shè)計的調(diào)查問卷收集納入居民的一般資料,由經(jīng)過嚴(yán)格培訓(xùn)的體檢人員對納入居民進行體格檢查。采用二步模型法測算居民的直接經(jīng)濟負擔(dān),采用人力資本法結(jié)合傷殘調(diào)整生命年(DALY)測算居民的間接經(jīng)濟負擔(dān),并與歸因危險度(PAR)相結(jié)合測算歸因于全身性肥胖、中心性肥胖的疾病經(jīng)濟負擔(dān)。結(jié)果居民的全身性肥胖患病率為6.8%(337/4 979),中心性肥胖患病率為38.4%(1 912/4 979);高血壓、糖尿病、冠心病、腦卒中患病率分別為35.3%(1 757/4 979)、9.9%(491/4 979)、3.8%(191/4 979)、1.7%(83/4 979)。多因素Logistic回歸分析結(jié)果顯示,控制了其他混雜因素后,全身性肥胖者患高血壓、糖尿病、冠心病、腦卒中的風(fēng)險分別為非全身性肥胖者的1.71、3.81、3.53、4.70倍,中心性肥胖者患高血壓、糖尿病、冠心病、腦卒中的風(fēng)險分別為非中心性肥胖者的2.21、1.92、1.61、2.10倍;消除全身性肥胖可使高血壓、糖尿病、冠心病、腦卒中的患病率分別下降4.61%、17.51%、14.68%、20.10%,消除中心性肥胖可使高血壓、糖尿病、冠心病、腦卒中的患病率分別下降32.50%、26.80%、19.53%、29.70%。居民高血壓、糖尿病、冠心病、腦卒中的人均疾病經(jīng)濟負擔(dān)分別為6 667.4、9 126.1、9 270.0、16 187.2元,總疾病經(jīng)濟負擔(dān)分別為108 185.2百萬元、41 529.5百萬元、16 192.0百萬元、12 649.0百萬元。4種常見慢性病歸因于全身性肥胖的經(jīng)濟負擔(dān)分別為8 167.6百萬元、6 876.6百萬元、3 491.7百萬元、2 740.2百萬元,歸因于中心性肥胖的經(jīng)濟負擔(dān)分別為34 370.2百萬元、10 696.1百萬元、3 232.4百萬元、3 177.0百萬元。4種常見慢性病的總疾病經(jīng)濟負擔(dān)為178 555.7百萬元,其中11.9%(21 276.1百萬元/178 555.7百萬元)歸因于全身性肥胖,28.8%(51 475.7百萬元/178 555.7百萬元)歸因于中心性肥胖。結(jié)論肥胖及4種相關(guān)慢性病給當(dāng)?shù)卦斐傻慕?jīng)濟負擔(dān)較重,降低全身性肥胖和中心性肥胖的患病率,有助于減輕該4種常見慢性病的經(jīng)濟負擔(dān)。
[Abstract]:Objective to investigate the economic burden of four common chronic diseases (hypertension, diabetes, coronary heart disease, stroke) in rural residents of Yunnan province. Methods from 2015 to September, the multi-stage stratified sampling method was used to select 5 040 residents from 12 administrative villages in Yunnan Province. Taking 4 979 cases completed the questionnaire as the research object, the self-designed questionnaire was used to collect the general information of the residents. The physical examination of the residents was carried out by strictly trained medical personnel, and the direct economic burden of the residents was calculated by using the two-step model method. The indirect economic burden of residents was calculated by using human capital method combined with DALY, and the attributive risk degree (par) was used to measure the overall obesity. The economic burden of central obesity. Results the prevalence of systemic obesity was 6. 8 / 4. 979). The prevalence of central obesity was 38.4% and 1 912/4 979%; The prevalence rates of hypertension, diabetes, coronary heart disease and stroke were 35.30.The prevalence of hypertension was 757/4 / 979 / 4.979 respectively. The results of multivariate Logistic regression analysis showed that other confounding factors were controlled. The risk of hypertension, diabetes, coronary heart disease and stroke in patients with general obesity were 1.71 鹵3.81 and 3.534.70 times of those with non-systemic obesity, respectively, and those with central obesity were high blood pressure. The risk of diabetes, coronary heart disease and stroke were 2.21 / 1.921.61 and 2.10 times of those of non-central obesity, respectively. Eliminating systemic obesity can reduce the prevalence of hypertension, diabetes, coronary heart disease and stroke by 4.61% and 17.51% and 14.68% respectively. The elimination of central obesity can reduce the prevalence of hypertension, diabetes, coronary heart disease and stroke by 32.50 and 26.80 respectively. The economic burden of coronary heart disease and stroke was 6 667.4 / 9 126.1 / 9 270.010 / 16187.2 yuan per capita, respectively. The total economic burden of disease was 108 185.2 million yuan, 41 529.5 million dollars and 16 192 million dollars respectively. The economic burden of 12 649.0 million, 4 common chronic diseases attributable to general obesity was 8 167.6 million yuan, 6 876.6 million yuan and 3 491.7 million yuan respectively. The economic burden attributable to central obesity was 34 370.2 million yuan, 10 696.1 million yuan and 3 232.4 million yuan respectively. 3 177.0 million yuan, 4 kinds of common chronic diseases, the total disease economic burden is 178 555.7 million yuan. Of these, 11.9m / 178,555.7 million were attributable to general obesity. 51,475.7 million yuan / 178,555.7 million yuan) was attributed to central obesity. Conclusion the economic burden caused by obesity and four kinds of related chronic diseases is heavy. Reducing the prevalence of systemic obesity and central obesity will help to reduce the economic burden of the four common chronic diseases.
【作者單位】： 昆明醫(yī)科大學(xué)公共衛(wèi)生學(xué)院衛(wèi)生事業(yè)管理與衛(wèi)生經(jīng)濟系;昆明醫(yī)科大學(xué)第一附屬醫(yī)院腎內(nèi)科;云南省昆明市宜良縣第一人民醫(yī)院院務(wù)部;
【基金】：國家自然科學(xué)基金資助項目(71263032) 云南省教育廳重大專項(Zd2014005) 昆明醫(yī)科大學(xué)重大科技成果培育項目(CGPY201503) 昆明醫(yī)科大學(xué)2016年博士研究生創(chuàng)新基金(2016D10)
【分類號】：R197.62;R589.2
【正文快照】： 1.650500云南省昆明市,昆明醫(yī)科大學(xué)公共衛(wèi)生學(xué)院衛(wèi)生事業(yè)管理與衛(wèi)生經(jīng)濟系2.650032云南省昆明市,昆明醫(yī)科大學(xué)第一附屬醫(yī)院腎內(nèi)科3.652100云南省昆明市宜良縣第一人民醫(yī)院院務(wù)部李青,蔡樂,王文麗,等.云南省農(nóng)村居民四種常見慢性病經(jīng)濟負擔(dān)及其與肥胖的關(guān)系研究[J].中國全科醫(yī)

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