[1]薛 原,穆耕林.中老年人慢性病累积速度的动态轨迹与健康结局关联研究 ——基于CHARLS数据的纵向分析[J].卫生经济研究,2025,42(10):62-66.
　XUE Yuan,MU Genglin.Study on the Dynamic Trajectory of Chronic Disease Accumulation Speed among Middle-aged and Elderly People and its Association with Health Outcomes ——A Longitudinal Analysis based on CHARLS Data[J].Journal Press of Health Economics Research,2025,42(10):62-66.
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中老年人慢性病累积速度的动态轨迹与健康结局关联研究
——基于CHARLS数据的纵向分析

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
42
期数:
2025年10期
页码:
62-66
栏目:
健康老龄化
出版日期:
2025-09-30

文章信息/Info

Title:
Study on the Dynamic Trajectory of Chronic Disease Accumulation Speed among Middle-aged and Elderly People and its Association with Health Outcomes
——A Longitudinal Analysis based on CHARLS Data
作者:
薛 原1; 2; 穆耕林1; 3; 4
1.中国药科大学国际医药商学院，江苏 南京 211198
2.南京中医药大学翰林学院，江苏 泰州 225300
3.南京大学中国医院改革发展研究院，江苏 南京 210008
4.南京大学医学院附属鼓楼医院，江苏 南京 210008
Author(s):
XUE Yuan;  MU Genglin
School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing Jiangsu 211198, China
关键词:
慢性病; 累积速度; 动态轨迹; 健康结局
Keywords:
chronic diseases;  accumulation rate;  dynamic trajectory;  health outcomes
分类号:
R19
文献标志码:
A
摘要:
目的：探讨我国中老年人慢性病累积速度的动态轨迹及影响，为制定慢性病差异化防控策略提供证据支持。方法：基于中国健康与养老追踪调查（CHARLS）5个观测周期的纵向数据，采用K-prototype聚类算法识别慢性病累积轨迹，构建广义估计方程（GEE）分析累积速度对健康结局的纵向效应。结果：我国中老年人慢性病累积轨迹具有异质性，低风险稳定型占29.01%、单病种稳定型占32.25%、双病种进展型占22.60%、多病种累积型占16.13%；47.43%的个体在中年向老年过渡阶段（2013年）出现慢性病数量最大增速；慢性病患病数量每增加1种，住院及门诊次数分别提升38.2%（IRR=1.382）和18.9%（IRR=1.189）；农村居住（OR=1.451）与高龄（OR=1.058）显著加剧日常生活能力恶化风险。结论：慢性病累积速度是独立于共病数量的动态风险因子，中年后期至老年初期为关键干预窗口；应构建以动态轨迹监测为核心的精准防控体系，针对双病种进展型人群，在50岁前启动代谢筛查与压力管理，同时加强农村地区的健康素养提升与医疗资源配置。
Abstract:
Objective To explore the dynamic trajectories and determinants of chronic disease accumulation rates among middle-aged and elderly people in China. Methods Based on the longitudinal data of five observation cycles from CHARLS, the K-prototype clustering algorithm was used to identify sub-types of chronic disease accumulation trajectories, and generalized estimating equations(GEE) were constructed to analyze the longitudinal effects of accumulation speed on health outcomes. Results The cumulative trajectory of chronic diseases among middle-aged and elderly people in China exhibited heterogeneity. 47.43% of individuals experienced the maximum growth rate during the transition from middle age to old age(2013). For every increase of 1 in the number of chronic diseases, number of inpatient and outpatient visits increased by 38.2%(IRR=1.382) and 18.9%(IRR=1.189), respectively. Rural residence(OR=1.451) and older age(OR=1.058) significantly exacerbated the risk of ADL deterioration. Conclusion It is recommended to build a precision prevention and control system with dynamic trajectory monitoring as core, start metabolic screening and stress management for the population with double disease progression before the age of 50, and strengthen the improvement of health literacy and resources allocation in rural areas.

参考文献/References:

[1] Yaohui Zhao,Yisong Hu,James P Smith,et al.Cohort Profile:The China Health and Retirement Longitudinal Study(CHARLS)[J].International Journal of Epidemiology,2014，43(01):61-68.
[2] 唐蓓，李彦章，张玉平.老年人日常生活活动能力的发展轨迹及影响因素追踪研究[J].成都医学院学报，2023，18（03）：314-318，339.
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更新日期/Last Update: 2025-09-30