云南省农村居民四种常见慢性病经济负担及其与肥胖的关系研究

发布时间：2018-02-04 14:14

本文关键词： 慢性病肥胖症患病代价农村卫生云南　出处：《中国全科医学》2017年07期 　论文类型：期刊论文

【摘要】：目的了解云南省农村居民4种常见慢性病(高血压、糖尿病、冠心病、脑卒中)的经济负担,并测算其归因于肥胖的疾病经济负担。方法于2015年1—9月采用多阶段分层抽样法,在云南省抽取12个行政村的5 040例居民,以完成问卷调查的4 979例为研究对象。采用自行设计的调查问卷收集纳入居民的一般资料,由经过严格培训的体检人员对纳入居民进行体格检查。采用二步模型法测算居民的直接经济负担,采用人力资本法结合伤残调整生命年(DALY)测算居民的间接经济负担,并与归因危险度(PAR)相结合测算归因于全身性肥胖、中心性肥胖的疾病经济负担。结果居民的全身性肥胖患病率为6.8%(337/4 979),中心性肥胖患病率为38.4%(1 912/4 979);高血压、糖尿病、冠心病、脑卒中患病率分别为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回归分析结果显示,控制了其他混杂因素后,全身性肥胖者患高血压、糖尿病、冠心病、脑卒中的风险分别为非全身性肥胖者的1.71、3.81、3.53、4.70倍,中心性肥胖者患高血压、糖尿病、冠心病、脑卒中的风险分别为非中心性肥胖者的2.21、1.92、1.61、2.10倍;消除全身性肥胖可使高血压、糖尿病、冠心病、脑卒中的患病率分别下降4.61%、17.51%、14.68%、20.10%,消除中心性肥胖可使高血压、糖尿病、冠心病、脑卒中的患病率分别下降32.50%、26.80%、19.53%、29.70%。居民高血压、糖尿病、冠心病、脑卒中的人均疾病经济负担分别为6 667.4、9 126.1、9 270.0、16 187.2元,总疾病经济负担分别为108 185.2百万元、41 529.5百万元、16 192.0百万元、12 649.0百万元。4种常见慢性病归因于全身性肥胖的经济负担分别为8 167.6百万元、6 876.6百万元、3 491.7百万元、2 740.2百万元,归因于中心性肥胖的经济负担分别为34 370.2百万元、10 696.1百万元、3 232.4百万元、3 177.0百万元。4种常见慢性病的总疾病经济负担为178 555.7百万元,其中11.9%(21 276.1百万元/178 555.7百万元)归因于全身性肥胖,28.8%(51 475.7百万元/178 555.7百万元)归因于中心性肥胖。结论肥胖及4种相关慢性病给当地造成的经济负担较重,降低全身性肥胖和中心性肥胖的患病率,有助于减轻该4种常见慢性病的经济负担。
[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 卤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.
【作者单位】：昆明医科大学公共卫生学院卫生事业管理与卫生经济系;昆明医科大学第一附属医院肾内科;云南省昆明市宜良县第一人民医院院务部;
【基金】：国家自然科学基金资助项目(71263032) 云南省教育厅重大专项(Zd2014005) 昆明医科大学重大科技成果培育项目(CGPY201503) 昆明医科大学2016年博士研究生创新基金(2016D10)
【分类号】：R197.62;R589.2
【正文快照】： 1.650500云南省昆明市,昆明医科大学公共卫生学院卫生事业管理与卫生经济系2.650032云南省昆明市,昆明医科大学第一附属医院肾内科3.652100云南省昆明市宜良县第一人民医院院务部李青,蔡乐,王文丽,等.云南省农村居民四种常见慢性病经济负担及其与肥胖的关系研究[J].中国全科医

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