[1]李文豪,李 晴,张天懿.中老年人家庭灾难性卫生支出影响因素研究[J].卫生经济研究,2025,42(12):23-27.
　LI Wenhao,LI Qing,ZHANG Tianyi.Study on Influencing Factors of Catastrophic Health Expenditure in Middle-Aged and Elderly Households in China[J].Journal Press of Health Economics Research,2025,42(12):23-27.
点击复制

中老年人家庭灾难性卫生支出影响因素研究

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
42
期数:
2025年12期
页码:
23-27
栏目:
聚焦医改
出版日期:
2025-12-02

文章信息/Info

Title:
Study on Influencing Factors of Catastrophic Health Expenditure in Middle-Aged and Elderly Households in China
作者:
李文豪1; 李 晴2; 张天懿1
1.天津中医药大学管理学院，天津 301617
2.青岛大学青岛医学院，山东 青岛 266003
Author(s):
LI Wenhao;  LI Qing;  ZHANG Tianyi
School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
关键词:
中老年人; 家庭灾难性卫生支出; 安德森卫生服务利用模型
Keywords:
middle-aged and elderly;  catastrophic health expenditure;  Anderson health services utilization model
分类号:
R197
文献标志码:
A
摘要:
目的：分析我国中老年人家庭灾难性卫生支出的影响因素，为积极应对人口老龄化提供决策依据。方法：基于2022年中国家庭追踪调查（CFPS）数据，选取户主为45岁及以上中老年人家庭为研究对象，基于安德森卫生服务利用模型理论，采用单因素分析、Logistic回归分析和Shapley值分解法，探究倾向特征、使能资源、需求因素对中老年人家庭灾难性卫生支出的影响。结果：4 691户中老年人家庭中，610户（13.00%）发生过灾难性卫生支出；单因素分析结果显示，年龄、文化程度、工作情况、居住地、家庭人均收入、家庭规模、就医偏好、自评健康状况、慢性病患病情况，对中老年人家庭灾难性卫生支出具有显著影响；Shapley值分解结果显示，对中老年人家庭灾难性卫生支出发生率影响较大的变量为年龄（15.95%）、家庭规模（15.61%）、自评健康状况（20.86%）和慢性病患病情况（10.29%）。结论：通过提供差异化帮扶、做好慢性病健康管理、完善困难人员就业援助制度等措施，改善中老年人家庭灾难性卫生支出现状。
Abstract:
Objective To analyze the influencing factors of catastrophic health expenditure in middle-aged and elderly households in China, and to provide a decision-making basis for actively responding to population aging. Methods Based on the 2022 China Family Panel Studies(CFPS) data, households with heads aged 45 and above were selected as the study subjects. Guided by Anderson health services utilization model, univariate analysis, logistic regression analysis, and Shapley value decomposition were used to explore the effects of predisposing characteristics, enabling resources, and need factors on catastrophic health expenditure. Results Among the 4 691 households surveyed, 610(13.00%) experienced catastrophic health expenditure. Univariate analysis revealed that age, education level, employment status, residence location, household income per capita, family size, healthcare preference, self-rated health status, and chronic disease conditions significantly influenced the incidence of catastrophic health expenditure. Shapley value decomposition indicated that the variables with the greatest contribution to the incidence of catastrophic health expenditure were self-rated health status(20.86%), age(15.95%), family size(15.61%), and chronic disease conditions(10.29%). Conclusion Differentiated assistance, improved health management for chronic diseases, and enhanced employment support systems for vulnerable populations should be implemented to alleviate the burden of catastrophic health expenditure among middle-aged and elderly households.

参考文献/References:

[1] 国家统计局.第七次全国人口普查主要数据情况[EB/OL].（2021- 05-11）[2025-02-20]. https://www.stats.gov.cn/sj/zxfb/202302/t2023 0203_1901080.html.
[2] Ahmad F,Mohanty P C.Incidence and intensity of catastrophic health expenditure and impoverishment among the elderly:an empirical evidence from India[J].Scientific Reports, 2024,14(01):1-19.
[3] Okamoto S,Sata M,Rosenberg M,et al.Universal health coverage in the context of population ageing:catastrophic health expenditure and unmet need for healthcare[J].Health Economics Review,2024,14(01):8-16.
[4] 张仲芳，刘海兰，刘星.我国灾难性卫生支出标准的界定：基于医疗支出对家庭基本生活消费的影响[J].中国卫生政策研究，2022，15（11）：68-74.
[5] 李月，杨霞，许静怡，等.我国中老年慢性病患者疾病经济风险研究——基于社会-人群-家庭层面[J].卫生经济研究，2023，40（02）：10-13.
[6] 姚强，谢佳.致贫性卫生支出视角下“因病致贫”对象界定方法及标准探究[J].中国卫生事业管理，2021，38（05）：321-324.
[7] 张礼亮，张婧怡，田佳帅，等.肺结核患者疾病负担现状及影响因素研究[J].卫生经济研究，2024，41（05）：36-40.
[8] 王苗，柴培培.我国老年慢性病共病模式及灾难性卫生支出分布研究[J].中国卫生经济，2024，43（08）：47-50.
[9] Kolasa A,Weychert E.The causal effect of catastrophic health expenditure on poverty in Poland[J].The European Journal of Health Economics,2024,25(02):193-206.
[10] 北京大学中国社会科学调查中心.中国家庭追踪调查[EB/OL]. （2022-05-18）[2024-12-19].https://www.isss.pku.edu.cn/cfps/index.htm.
[11] Xu X,Yang H.Elderly chronic diseases and catastrophic health expenditure:An important cause of Borderline Poor Families′return to poverty in rural China[J].Humanities and Social Sciences Communications,2022,9(01):1-10.
[12] Liu S,Coyte P C,Fu M,et al.Measurement and determinants of catastrophic health expenditure among elderly households in China using longitudinal data from the CHARLS[J].International Journal for Equity in Health,2021,20(01):1-9.
[13] Li J,Gao T,Zhao D,et al.Catastrop hic health expenditure and health-related quality of life among older adults in Shandong, China: the moderation effect of daily care by adult children[J].International Journal for Equity in Health,2024,23(01):51-61.
[14] 苏文钰，葛怀举，常雯静，等.我国中老年人慢性病共病关联规则分析及相关因素识别研究[J].现代预防医学，2024，51（24）：4417-4422.
[15] 巴曙松，黄开怀.中国居民退休准备与延迟退休影响的评估[J].人口与经济，2025（01）：1-19.
[16] Chen B,Zeng N,Tam K P.Do social networks affect household financial vulnerability? Evidence from China[J].Finance Research Letters,2024,59:104710.
[17] Fonseca G,de Sousa B,Crespo C,et al.Economic strain and quality of life among families with emerging adult children:the contributions of family rituals and family problem-solving communication[J].Family process,2024,63(03):1319-1335.
[18] Mohsin K F,Ahsan M N,Haider M Z.Understanding variation in catastrophic health expenditure from socio-ecological aspect:a systematic review[J].BMC Public Health,2024,24(01):1-24.
[19] Reddy U S.Measurement of Catastrophic Health Expenditure in India: a systematic review and meta-analysis[J].Applied Health Economics and Health Policy,2024,22(04):471-483.
[20] 李乐乐，徐莹，杜奕，等.慢性病患者家庭灾难性卫生支出风险及其不平等性研究[J].卫生经济研究，2022，39（12）：53-56.

相似文献/References:

[1]许建强,郑 娟,李佳佳,等.全民健康覆盖下城乡家庭灾难性卫生支出测量及差异分析[J].卫生经济研究,2019,(03):35.
　XU Jian-qiang,ZHENG Juan,LI Jia-jia,et al.Measurement and Difference Analysis of Catastrophic Health Expenditure of Urban and Rural Households under the Coverage of National Health[J].Journal Press of Health Economics Research,2019,(12):35.
[2]贡 悦,汤少梁,倪语初,等.劳动参与与中老年人卫生服务利用的关联分析3 ——以健康水平为中介变量[J].卫生经济研究,2024,41(06):44.
　GONG Yue,TANG Shaoliang,NI Yuchu,et al.Association Analysis of Labor Force Participation and Health Service Utilization among Middle-aged and Elderly People ——Using Health Level as a Mediator Variable[J].Journal Press of Health Economics Research,2024,41(12):44.

更新日期/Last Update: 2025-12-02