目的：了解江西省农村地区老年人的慢性病患病状况，评价不同经济收入老年人的慢性病患病公平性。方法本研究的所有资料均来源于南昌大学公共卫生学院“江西省农村居民家庭健康状况及医疗卫生服务需求利用调查”课题组对江西省农村地区2003年（婺源县）、2004年（芦溪县、修水县）的卫生服务基线调查和2006年、2008年、2010年及2012年的4次追踪调查。本研究选取其中年龄≥65岁的老年人为研究对象，最终确定5次调查的研究对象分别为631、631、833、615及667人。按家庭人均年收入由低到高排序，采用五类分组法将其分为Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ组。对调查资料进行纵向对比研究，以患病率描述慢性病的患病状况，以集中指数（ CI）和不平等斜率指数（ SII）为公平性评价指标，根据2012年的调查资料进行慢性病病种构成分析。结果江西省农村地区基线调查及2006年、2008年、2010年、2012年追踪调查的老年人慢性病患病率分别为28.9%（16257/56329）、27.6%（18957/68621）、25.7%（20541/79952）、25.4%（20608/81134）及22.7%（18524/81600），呈逐年下降趋势（χ2趋势＝769.74，P﹤0.05）；5次调查中不同经济收入组的老年人慢性病患病率比较，差异均有统计学意义（ P ﹤0.05），CI和SII均为负值，︳ CI︳均在0.3以内。2012年老年人慢性病患病以循环、血液系统疾病为主，患病率为14.5%（11833/81600），构成比为63.9%（11833/18524）。结论江西省农村地区老年人的慢性病患病率较低，且呈逐年下降趋势，公平性总体状况良好；高血压和心脏病等循环系统疾病的预防和控制有待加强。%Objective To investigate the prevalence of chronic diseases among elderly population in rural areas in Jiangxi Province,and evaluate its equity among different income groups. Methods In this study,the data were obtained from the" investigation on health condition and health service needs of rural households in Jiangxi Province",which was conducted by the School of Public Health of Nanchang University. The investigation included a health service baseline survey in Wuyuan County in 2003,Xiushui County and Luxi County in 2004 and four follow-up surveys in the three counties in 2006,2008,2010,and 2012. We selected respondents aged no less than 65 years old. The numbers of respondents in the five surveys were 631,631, 833,615 and 667 respectively. The respondents were ranked by annual per capita income from low to high and were grouped into five group,including GroupⅠ,Ⅱ,Ⅲ,Ⅳ,and Ⅴ. A longitudinal comparative study was performed using the data from the surveys. Prevalence rate was applied to describe the conditions of chronic diseases;CI and SII were used as equity evaluation indicators;the survey data of 2012 were used to analyze chronic disease types. Results The results of the surveys showed the prevalence rates of chronic diseases among elderly population in rural areas in Jiangxi were 28. 9%( 16 257/56 329 ),27. 6%(18 957/68 621),25. 7%(20 541/79 952),25. 4%(20 608/81 134)and 22. 7%(18 524/81 600)respectively in the baseline survey and in the four follow -up surveys,in which a declining trend was noted(χ2 =769. 74,P ﹤0. 05). The prevalence rates among different income groups were statistically different(P﹤0. 05)for the five surveys. Both CI and SII were negative. All the absolute values of CI were within 0. 3. Disease types analysis showed that the main chronic disease that elderly population in rural areas in Jiangxi suffered from was circulatory system diseases,prevalence rate 14. 5%(11 833/81 600), accounting for 63. 9%(11 833/18 524)in all the elderly chronic disease patients. Conclusion The prevalence rate of chronic diseases among elderly population in rural areas in Jiangxi is relatively lower,showing a declining trend. Its equity is overall in a good condition. The prevention and control of circulatory system diseases,such as hypertension and heart disease,needs to be strengthened.
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