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目的了解四川省农村地区慢性病患者健康相关生命质量,同时采用Tobit模型分析其影响因素。方法利用2013年四川省第五次国家卫生服务调查的数据,采用欧洲五维健康量表(EQ-5D)计算农村地区慢性病患者健康效用值,并拟合Tobit模型探讨影响健康效用值的因素。结果农村地区慢性病患者健康效用值为0.870。影响农村慢性病患者健康效用值的因素包括年龄、性别、到医疗点距离及体质量指数(BMI):50~59岁组〔偏回归系数(β)=-0.071 6,P=0.001〕、60~69岁组(β=-0.138 0,P<0.001)、70岁及以上组(β=-0.230 9,P<0.001)健康效用值都低于50岁以下年龄组,女性患者的健康效用值低于男性(β=-0.032 0,P=0.023),到医疗点的距离3km及以下的患者健康效用值高于3km以上组(β=-0.038 0,P=0.019),偏瘦(BMI<18.5kg/m2)的患者健康效用值低于BMI正常组(β=-0.081 5,P<0.001)。结论 Tobit模型能较好地解决因变量受限的问题。四川农村地区慢性病患者生命质量较低。
Objective To understand the health-related quality of life of patients with chronic diseases in rural areas of Sichuan Province, Tobit model was used to analyze the influencing factors. Methods Based on the data from the fifth national health service survey in Sichuan Province in 2013, EQ-5D was used to calculate the health utility of patients with chronic diseases in rural areas. The Tobit model was fitted to explore the factors affecting the health utility value. Results The health utility value of patients with chronic diseases in rural areas was 0.870. The factors affecting the health utility value of patients with chronic diseases in rural areas included age, sex, distance from the medical center and body mass index (BMI): 50 to 59 years old (partial regression coefficient (β) = -0.071 6, P = 0.001) The health utility values of patients aged less than 70 years in the age group of 69 (β = -0.138 0, P <0.001) and those in the age group of 70 and older (β = -0.230 9, P <0.001) The health utility of patients with a distance of less than 3km from the medical sites was higher than that of the patients with a distance of more than 3km (β = -0.038 0, P = 0.019) and the lean (BMI <18.5 kg / m2) were lower than those in the normal BMI group (β = -0.081 5, P <0.001). Conclusion Tobit model can solve the problem of limited dependent variable. Chronic diseases in rural areas in Sichuan lower quality of life.