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山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (4): 113-118.doi: 10.6040/j.issn.1671-7554.0.2021.0062

• • 上一篇    

农村老年人医疗保险参与和自杀风险的关系

赵思博,彭立,凌鸿翔   

  • 发布日期:2022-04-22
  • 通讯作者: 赵思博. E-mail:sibozhao@cufe.edu.cn
  • 基金资助:
    北京社会科学基金(19SRC013)

Relationship between medical insurance participation and risk of suicide among rural elderly

ZHAO Sibo, PENG Li, LING Hongxiang   

  1. School of Sociology and Psychology, Central University of Finance and Economics, Beijing 100081, China
  • Published:2022-04-22

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摘要： 目的 探讨农村老年人医疗保险参与行为与自杀风险的关系。 方法 采用“2010年中国城乡老年人口状况追踪调查数据”。该调查以年满60周岁及以上老年人为调查对象,采用与规模呈正比的分层随机抽样方法,对20个省、自治区、直辖市展开调查。研究采用的农村地区老年人有效样本为7 873人。问卷中包含了基本人口统计学信息、医疗保险和自杀风险等相关问题。采用二分类Logistic回归模型进行分析。 结果 农村老年人自杀风险报告率为6.03%,并在不同参保行为的群体中具有显著差异(χ2=9.42, P=0.002)。二分类Logistic回归模型分析显示,与自杀风险相关的因素有医疗保险(OR=0.513,95%CI=0.285~0.922)、文化程度(小学:OR=0.718,95%CI=0.573~0.898;初中及以上:OR=0.670,95%CI=0.453~0.989)、是否负债(OR=1.557,95%CI=1.236~1.962)、经济保障(OR=0.719,95%CI=0.574~0.900)、身体状况(较差:OR=0.768,95%CI=0.572~1.031;一般:OR=0.307,95%CI=0.224~0.420;较好:OR=0.316,95%CI=0.206~0.486;很好:OR=0.175,95%CI=0.061~0.494)、有无慢性病(OR=1.970,95%CI=1.448~2.681)、心理负担(OR=1.027,95%CI=1.015~1.039)、家庭关系(OR=0.350,95%CI=0.253~0.484)等。 结论 医疗保险参与行为与自杀风险显著相关。提高医疗保险在农村地区的覆盖率和保障水平,探索和完善农村大病救助体系,有助于改善农村老年人精神健康状况,降低自杀行为的发生风险。

关键词: 农村老年人, 医疗保险, 自杀风险, 影响因素

Abstract: Objective To investigate the relationship between medical insurance participation and risk of suicide among rural elderly. Methods The “2010 China Urban and Rural Elderly Population Tracking Survey Data” were mined. Using a stratified random sampling method of proportional to the scale, elderly aged 60 years and above were surveyed in 20 provinces, autonomous regions, and municipalities. Altogether 7 873 subjects were enrolled, who were surveyed with a questionnaire composed of basic demographic information, medical insurance participation, suicidal behaviors and other related questions. Data collected were analyzed with a binary Logistic regression model. Results The reported risk of suicide among rural elderly was 6.03%, and there was significant differences among groups with different insurance participations(χ2=9.42, P=0.002). The binary Logistic regression model showed that factors related to risk of suicide included health insurance(OR=0.513, 95%CI=0.285-0.922), education level(elementary school: OR=0.718, 95%CI=0.573-0.898; junior high school and above: OR=0.670, 95%CI=0.453-0.989), debt status(OR=1.557, 95%CI=1.236-1.962), financial security(OR=0.719, 95%CI=0.574-0.900), health status(poor: OR=0.768, 95%CI=0.572-1.031; fair: OR=0.307, 95%CI=0.224-0.420; good: OR=0.316, 95%CI=0.206-0.486; very good: OR=0.175, 95%CI=0.061-0.494), chronic diseases(OR=1.970, 95%CI=1.448-2.681), psychological burden(OR=1.027, 95%CI=1.015-1.039), family relationship(OR=0.350, 95%CI=0.253-0.484), and so on. Conclusion Medical insurance participation is significantly related to the risk of suicide. Enhancing the coverage rate and insurance level and improving the rural serious diseases relief system will help improve the mental health of rural elderly and reduce the risk of suicide.

Key words: Rural elderly, Medical insurance, Risk of suicide, Influencing factors

中图分类号: 

  • R574
[1] 高欣, 金叶, 汪媛, 等. 2006—2016年中国自杀死亡及自残/自杀病例流行特征分析[J]. 中华预防医学杂志, 2019, 53(9): 885-890. GAO Xin, JIN Ye, WANG Yuan, et al. Analysis on suicide mortality and self-inflicted injury/suicide hospital cases in China from 2006 to 2016 [J]. Chin J Prev Med, 2019, 53(9): 885-890.
[2] World Health Organization. Suicide in the world: global health estimates [EB/OL]. [2019-09-09]. https://apps.who.int/iris/handle/10665/326948.
[3] 刘肇瑞, 黄悦勤, 马超, 等. 2002—2015年我国自杀率变化趋势[J]. 中国心理卫生杂志, 2017, 31(10): 756-767. LIU Zhaorui, HUANG Yueqin, MA Chao, et al. Suicide rate trends in China from 2002 to 2015 [J]. Chinese Mental Health Journal, 2017, 31(10): 756-767.
[4] 国家卫生和计划生育委员会. 2013中国卫生和计划生育统计年鉴[M]. 北京: 中国协和医科大学出版社,2013.
[5] OConnor Rory C, Nock Matthew K. The psychology of suicidal behavior [J]. The Lancet Psychiatry, 2014, 1(1):73-85.
[6] 杜睿, 江光荣. 自杀行为: 影响因素、理论模型及研究展望[J]. 心理科学进展, 2015, 23(8): 1437-1452. DU Rui, JIANG Guangrong. Suicidal behaviors: risk factor, psychological theory and future research [J]. Advances in Psychological Science, 2015, 23(8): 1437-1452.
[7] Sha F, Chang Q, Law YW, et al. Suicide rates in China, 2004-2014: comparing data from two sample-based mortality surveillance systems [J]. BMC Public Health, 2018, 18(1): 239.
[8] Wang CW, Chan CL, Yip PS. Suicide rates in China from 2002 to 2011: an update [J]. Soc Psychiatry Psychiatr Epidemiol, 2014, 49(6): 929-941.
[9] 刘燕舞. 农村老年人自杀及其危机干预(1980—2009)[J]. 南方人口, 2013, 28(2): 57-64. LIU Yanwu. The suicides of the rural elderly and the crisis intervention in China: 1980-2009 [J]. South China Population, 2013, 28(2): 57- 64.
[10] 袁同成, 沈宫阁. 农村老年福利供给体系重构的精神健康效应[J]. 西北大学学报(哲学社会科学版), 2016, 46(6): 126-134. YUAN Tongcheng, SHEN Gongge. Research on the mental health effect of rural elderly welfare provision structure reconstruction [J]. Journal of Northwest University(Philosophy and Social Sciences Edition), 2016, 46(6): 126-134.
[11] 朱坤, 张小娟, 朱大伟. 整合城乡居民基本医疗保险制度筹资政策分析: 基于公平性视角[J]. 中国卫生政策研究, 2018, 11(3): 46-50. ZHU Kun, ZHANG Xiaojuan, ZHU Dawei. Analysis of the financing policy of integrating NCMS and URBMI: Based on the perspective of equity [J]. Chinese Journal of Health Policy, 2018, 11(3): 46-50.
[12] Chen S, Chen Y, Feng Z, et al. Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: a systematic review and policy gap analysis [J]. BMC Public Health, 2020, 20(1): 408.
[13] Li C, Tang C, Wang H. Effects of health insurance integration on health care utilization and its equity among the mid-aged and elderly: evidence from China [J]. Int J Equity Health, 2019, 18(1): 166.
[14] Zhong BL, Chiu HF, Conwell Y. Elderly suicide trends in the context of transforming China, 1987-2014 [J]. Sci Rep, 2016, 6: 37724. doi:10.1038/srep37724.
[15] 王珊, 陈欧, 赵妹, 等. 中国老年人自杀意念发生率的Meta分析[J]. 护理研究, 2020, 34(5): 806-813. WANG Shan, CHEN Ou, ZHAO Mei, et al. The prevalence of suicide ideation among the Chinese elderly: a Meta-analysis [J]. Chinese Nursing Research, 2020, 34(5): 806-813.
[16] Xu H, Zhang W, Wang X, et al. Prevalence and influence factors of suicidal ideation among females and males in Northwestern urban China: a population-based epidemiological study [J]. BMC Public Health, 2015, 15: 961. doi: 10.1186/s12889-015-2257-5.
[17] Tian D, Qu Z, Wang X, et al. The role of basic health insurance on depression: an epidemiological cohort study of a randomized community sample in northwest China [J]. BMC Psychiatry, 2012, 12: 151. doi: 10.1186/1471-244x-12-151.
[18] 刘燕舞. 农村家庭养老之殇: 农村老年人自杀的视角[J]. 武汉大学学报(人文科学版), 2016(4): 13-16. LIU Yanwu. The problem of family pension in rural China: an elderly suicide perspective[J]. Wuhan University Journal(Humanity Sciences), 2016(4): 13-16.
[19] Yang Q, Xu Q, Lu Y, et al. The impact of public health insurance on household credit availability in rural China: evidence from NRCMS [J]. Int J Environ Res Public Health, 2020, 17(18): 6595.
[20] Wang Y, Zhu Y, Shi H, et al. The effect of the full coverage of essential medicines policy on utilization and accessibility of primary healthcare service for rural seniors: a time series study in Qidong, China [J]. Int J Environ Res Public Health, 2019, 16(22): 4316.
[21] Crawford MJ, Nur U, McKenzie K, et al. Suicidal ideation and suicide attempts among ethnic minority groups in England: results of a national household survey [J]. Psychol Med, 2005, 35(9): 1369-1377.
[22] Zhang D, Yang Y, Sun Y, et al. Characteristics of the Chinese rural elderly living in nursing homes who have suicidal ideation: a multiple regression model [J]. Geriatr Nurs, 2017, 38(5): 423-430.
[23] Wei J, Zhang J, Deng Y, et al. Suicidal ideation among the Chinese elderly and its correlates: a comparison between the rural and urban populations [J]. Int J Environ Res Public Health, 2018, 15(3): 422.
[24] Cheah YK, Azahadi M, Phang SN, et al. Sociodemographic, lifestyle and health determinants of suicidal behaviour in Malaysia [J]. Psychiatry Res, 2018, 261: 319-324. doi: 10.1016/j.psychres.2017.12.086.
[25] Lu L, Xu L, Luan X, et al. Gender difference in suicidal ideation and related factors among rural elderly: a cross-sectional study in Shandong, China [J]. Ann Gen Psychiatry, 2020, 19: 2. doi: 10.1186/s12991-019-0256-0.
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