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利用中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)数据,实证分析了老年慢病家庭灾难性卫生支出风险及相关影响因素,同时测算了灾难性卫生支出风险的不平等及其决定因素。中国老年慢病家庭灾难性卫生支出风险较高,且存在倾向于低收入家庭的不平等。农村低收入老年慢病家庭灾难性卫生支出的发生率和发生强度最高。家庭相关因素和慢病患者的就医行为会显著影响老年慢病家庭灾难性卫生支出的发生率和发生强度,同时也决定了灾难性卫生支出风险的不平等。政府应当对老年慢病人群特别是农村低收入老年慢病人群提供系统性的经济风险保护,降低疾病的经济负担。
Using the data of China Health and Retirement Longitudinal Study (CHARLS), we analyzed the risk of catastrophic health expenditure and its related factors in elderly people with chronic diseases, and calculated the inequality of catastrophic health expenditure risk and its decision factor. There is a high risk of disastrous health expenditures in China’s elderly chronic illness families, and there is inequality towards low-income families. The incidence and intensity of catastrophic health expenditures of rural low-income elderly people with chronic diseases are the highest. Family-related factors and the behavior of people with chronic illnesses significantly affect the incidence and intensity of catastrophic health expenditures among the elderly, and also determine the inequities in the risk of catastrophic health expenditures. The government should provide systemic economic risk protection to elderly people with chronic diseases, especially low-income elderly people with chronic diseases in rural areas, and reduce the economic burden of diseases.