近日，我院姚強副教授及其合作者在衛(wèi)生管理國際權威期刊《BMJ Global Health》發(fā)表題為“Decomposing Income-Related Inequality in Health-Related Quality of Life in Mainland China: A National Cross-Sectional Study”的原創(chuàng)性研究成果。

  文章簡介：健康與公平是衛(wèi)生系統(tǒng)的重要目標，了解居民的健康公平性對于衛(wèi)生的評價及政策制定具有重要意義。本研究通過全國性的中國居民心理與行為調查研究(Psychology and Behavior Investigation of Chinese Residents, PBICR)，利用集中指數(shù)及其分解方法和EQ-5D-5L量表，分析了我國居民健康相關生命質量的不平等水平及其影響因素，結果顯示，我國健康不平等水平總體較低但是仍然存在親富性不平等，健康素養(yǎng)、慢性病患病以及經濟收入水平是導致健康不平等在主要因素，農村和西部地區(qū)健康不平等水平相對較高。因此，降低居民健康素養(yǎng)、慢性病及其經濟收入不平等情況，尤其是農村和西部不發(fā)達地區(qū)，對于提高衛(wèi)生系統(tǒng)的公平性具有重要意義。

   Abstract：Introduction Health equity is an important indicator measuring social development and solidarity. However, there is a paucity in nationwide studies into the inequity in health-related quality of life (HRQoL) in mainland China, in particular using the most recent data measuring HRQoL using the EuroQol 5-Dimension-5 Level (EQ-5D-5L). This study aimed to address the gap in the literature by estimating and decomposing income-related inequality of the utility index (UI) of EQ-5D-5L in mainland China.

     Methods Data were extracted from the Psychology and Behaviour Investigation of Chinese Residents (2022), including 19 738 respondents over the age of 18 years. HRQoL was assessed by the UI of the EQ-5D-5L. Concentration index (CI) was calculated to measure the degree of income-related inequality in the UI. The contributions of individual, behavioural and context characteristics to the CI were estimated using the Wagstaff decomposition method.

     Results The CI of the EQ-5D-5L UI reached 0.0103, indicating pro-rich inequality in HRQoL. Individual characteristics made the greatest contribution to the CI (57.68%), followed by context characteristics (0.60%) and health behaviours (?3.28%). The contribution of individual characteristics was mainly attributable to disparities in the enabling (26.86%) and need factors (23.86%), with the chronic conditions (15.76%), health literacy (15.56%) and average household income (15.24%) as the top three contributors. Educational level (?5.24%) was the top negative contributor, followed by commercial (?1.43%) and basic medical insurance (?0.56%). Higher inequality was found in the least developed rural (CI=0.0140) and western regions (CI=0.0134).

      Conclusion Pro-rich inequality in HRQoL is evident in mainland China. Targeted interventions need to prioritise measures that aim at reducing disparities in chronic conditions, health literacy and income.

  論文鏈接地址：https://gh.bmj.com/content/8/11/e013350.full。

作者簡介：姚強，武漢大學政治與公共管理學院副教授，公共事業(yè)管理系副主任，武漢大學健康治理研究中心副主任，武漢大學社會保障研究中心、國家醫(yī)療保障研究院華科基地研究員，澳大利亞La Trobe大學訪問學者，《中國醫(yī)院管理》雜志青年編委。目前，在Bulletin of the World Health Organization, BMJ Global Health, Journal of Global Health, International Journal for Equity in Health, Health and Quality of Life Outcomes, Health Research Policy and Systems, 人口與發(fā)展，統(tǒng)計與信息論壇，中國衛(wèi)生政策研究等國內外雜志發(fā)表學術論文100余篇，中國社會科學出版社出版?zhèn)€人學術專著1部，參編《醫(yī)療保障學》《衛(wèi)生信息資源規(guī)劃與管理》《文獻綜述與開題報告》《醫(yī)院管理與衛(wèi)生政策研究方法》等國家、省部級規(guī)劃教材4部。主持國家級、省部級和學校各類項目共20余項。主要研究領域為衛(wèi)生服務、健康保障、健康公平等。

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