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山东大学学报 (医学版) ›› 2025, Vol. 63 ›› Issue (7): 82-91.doi: 10.6040/j.issn.1671-7554.0.2025.0116

• 公共卫生与预防医学 • 上一篇    下一篇

中国中老年高血糖、血脂异常、高血压人群健康体检服务利用现状及影响因素

王宁1,郝秀梅1,牛翔2,黄金明3,徐静雅4   

  1. 1.山东省卫生健康宣传教育中心, 山东 济南 250002;2.济南市槐荫区疾病预防控制中心, 山东 济南 250021;3.山东省疾病预防控制中心, 山东 济南 250014;4.山东第一医科大学附属省立医院护理部, 山东 济南 250021
  • 发布日期:2025-07-08
  • 通讯作者: 黄金明. E-mail:hjm1023@163.com
  • 基金资助:
    山东省公共卫生体系建设研究课题(GWY202349);山东省中医药科技项目(Q-2023025);山东省医药卫生科技项目(202312071333)

Status and influencing factors of health check-up services utilisation among middle-aged and elderly populations with hyperglycaemia, dyslipidaemia, and hypertension in China

WANG Ning1, HAO Xiumei1, NIU Xiang2, HUANG Jinming3, XU Jingya4   

  1. 1. Health Publicity and Education Center of Shandong Province, Jinan 250002, Shandong, China;
    2. Huaiyin District Center for Disease Control and Prevention, Jinan 250021, Shandong, China;
    3. Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong, China;
    4. Nursing Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Published:2025-07-08

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摘要： 目的 了解我国中老年高血糖、血脂异常、高血压人群健康体检服务利用现状并分析其影响因素,为优化“三高共管”策略和卫生服务体系改革提供依据。 方法 依托中国健康与养老追踪调查(China health and retirement longitudinal study, CHARLS)于2020年开展的第五轮调查数据,共筛选中老年高血糖、血脂异常、高血压患者8 227人作为研究对象,基于安德森模型框架,采用χ2检验和多因素Logistic回归分析影响我国中老年高血糖、血脂异常、高血压人群健康体检服务利用的主要因素。 结果 研究对象体检服务利用率为54.13%。多因素Logistic回归分析结果显示年龄(≥65岁:OR=2.024,95%CI=1.831~2.236,P<0.001)、受教育程度(高中及以上:OR=1.303, 95%CI=1.123~1.511,P<0.001)、个人收入(有:OR=1.440,95%CI=1.285~1.614,P<0.001)、养老保险类别(企业职工养老保险:OR=0.655,95%CI=0.516~0.833,P<0.001;城镇居民/城乡居民养老保险:OR=0.633,95%CI=0.493~0.813,P<0.001;新型农村居民社会养老保险:OR=0.602,95%CI=0.466~0.778,P<0.001;其他养老保险:OR=0.549,95%CI=0.390~0.772,P<0.001;无养老保险:OR=0.473,95%CI=0.361~0.619,P<0.001)、医保类别(新农合、其他医保、无医保:OR=0.834,95%CI=0.726~0.959,P=0.011)、抑郁症状(是:OR=0.885,95%CI=0.804~0.975,P=0.014)、慢性病患病数量(2种:OR=1.158,95%CI=1.004~1.337,P=0.045;3种:OR=1.273,95%CI=1.099~1.475,P=0.001;≥4种:OR=1.282,95%CI=1.117~1.472,P<0.001)、社交情况(有:OR=1.396,95%CI=1.274~1.530,P<0.001)、住院服务利用(利用/需求:OR=1.207,95%CI:1.080~1.348,P<0.001)、饮酒(是:OR=1.127, 95%CI=1.019~1.246,P=0.020)及吸烟(是:OR=0.761,95%CI=0.681~0.849,P<0.001)是影响我国中老年高血糖、血脂异常、高血压人群健康体检服务利用的主要因素。 结论 我国中老年高血糖、血脂异常、高血压人群体检服务利用率有待提高,建议将45~64岁人群纳入弹性体检补贴范围,推动体检费用医保报销,减轻贫困人群经费负担;深化医防融合机制,创新技术赋能,简化体检流程;加强慢性病防控政策及健康宣教,提升居民健康素养水平和健康管理依从性;针对低收入、低教育水平、有抑郁症状等人群,制定定向干预方案,实现慢性病防控关口前移,促进健康老龄化。

关键词: 中老年, 高血糖, 血脂异常, 高血压, 健康体检服务利用, 影响因素

Abstract: Objective By exploring the current situation of the utilisation of health check-up services and its influencing factors among middle-aged and elderly populations with hyperglycaemia, dyslipidaemia and hypertension in China, to provide evidence to optimise the strategy of “co-management of hyperglycaemia, dyslipidaemia and hypertension”, and reform the health service system. Methods According to the fifth round of national survey data conducted by China Health and Retirement Longitudinal Study(CHARLS)in 2020, a total of 8,227 middle-aged and elderly individuals with hyperglycaemia, dyslipidaemia, and hypertension were selected as the study populations. The analysis of the utilisation of health check-up services among these populations was conducted utilising the chi-square test and multivariate logistic regression based on the Anderson model framework. Results Among middle-aged and elderly individuals with hyperglycaemia, dyslipidaemia, and hypertension, utilisation rate of health check-up was 54.13%. The results of multivariate logistic regression analysis showed that: age(≥65 years old: OR=2.024, 95%CI=1.831-2.236, P<0.001), education level(senior high school and above: OR=1.303, 95%CI=1.123-1.511, P<0.001), personal income(have: OR=1.440, 95%CI=1.285-1.614, P<0.001), type of endowment insurance(enterprise employee endowment insurance: OR=0.655, 95%CI=0.516-0.833, P<0.001; urban resident/urban and rural resident endowment insurance: OR=0.633, 95%CI=0.493-0.813, P<0.001; new rural social endowment insurance: OR=0.602, 95%CI=0.466-0.778, P<0.001; other endowment insurance: OR=0.549, 95%CI=0.390-0.772, P<0.001; no endowment insurance: OR=0.473, 95%CI=0.361-0.619, P<0.001), type of medical insurance(new rural cooperative medical insurance/ other medical insurance/ no medical insurance: OR=0.834, 95%CI=0.726-0.959, P=0.011), depression status(yes:OR=0.885, 95%CI=0.804-0.975, P=0.014), number of chronic diseases(2 types: OR=1.158, 95%CI=1.004-1.337, P=0.045; 3 types: OR=1.273,95%CI=1.099-1.475, P=0.001; ≥4 types: OR=1.282, 95%CI=1.117-1.472, P<0.001), social contacts(yes:OR=1.396, 95%CI=1.274-1.530, P<0.001), utilization of inpatient services(yes/demand: OR=1.207, 95%CI:1.080-1.348, P<0.001), alcohol consumption(OR=1.127, 95%CI=1.019-1.246, P=0.020), and smoking behavior(OR=0.761, 95%CI=0.681-0.849, P<0.001)were the primary factors influencing the utilisation of health check-up services. Conclusion The utilization rate of health check-up services among middle-aged and elderly individuals with hyperglycaemia, dyslipidaemia, and hypertension in China requires improvement. It is recommended to implement flexible health check-up subsidies for individuals aged 45-64 years, promote reimbursement of health check-up fees through health insurance, and alleviate the financial burden on impoverished populations. Furthermore, the integration of medical care and prevention should be strengthened, with innovative technologies employed to simplify health check-up processes. The enhancement of policies pertaining to the prevention and control of chronic diseases, in conjunction with health education, is of paramount importance in enhancing residents health literacy and adherence to health management. The development of targeted intervention programmes is imperative for individuals with low income, low educational attainment, and depression status, with the objective of promoting the prevention and management of chronic diseases at an earlier stage and facilitating healthy ageing.

Key words: Middle-aged and elderly individuals, Hyperglycaemia, Dyslipidaemia, Hypertension, Utilisation of health check-up services, Influencing factors

中图分类号: 

  • R195.4
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