人口老龄化背景下阿尔茨海默病患者卫生服务利用与经济保护模型研究

项目名称： 人口老龄化背景下阿尔茨海默病患者卫生服务利用与经济保护模型研究

项目编号： No.81502880

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 赵艳芳

作者单位： 中国人民解放军第二军医大学

项目金额： 18万元

中文摘要： 我国已进入人口老龄化高峰期，阿尔茨海默病(AD)成为我国老龄化背景下的严重公共卫生问题。本研究拟通过多阶段分层随机抽样的人群流行病学调查，在我国东部、中部和西部开展研究，获取老年人AD患者卫生服务利用相关资料，分析AD患者卫生服务利用的现状，并针对数据特征，基于多水平结构方程模型，分析卫生服务可及性、卫生服务质量、家庭照顾、社会支持、家庭经济特征等潜变量对AD患者卫生服务利用的影响。同时采用灾难性医疗支出、因病致贫、医疗保险、住院报销等指标测量AD患者家庭经济风险保护能力，构建卫生服务利用与家庭经济保护相互作用模型。根据分析结果，采用专家咨询法，提出政策建议，构建针对性的AD患者社会服务体系。本研究能为有针对性提高AD患者家庭经济保护能力，有效开展AD防控工作提供决策支持，最终将对防控AD，提高AD患者生命质量产生深远影响。

中文关键词： 人口老龄化；阿尔茨海默病；卫生服务利用；经济保护；多水平结构方程模型

英文摘要： China has entered a period with peak population aging, and Alzheimer’s disease (AD) has become a serious problem of public health under the background of population aging. In this study, we want to carry out an epidemiological survey ,using a multiple-stage, stratified and random sampling method in the eastern, middle and western China. The study is to obtain the data on health service utilization of old people with AD.The present situation of the health service utilization of AD patients will be analysed, and multilevel structure equation model will be constructed according to the characteristics of the data. The relationship between health service utilization and latent variables, including access to health services, quality of health services, family care, society support, economic characteristics of family, and so on, will be analysed. The index, including catastrophic health expenses, poverty due to illness, medical insurance, inpatient reimbursement, and so on, will be used to measure the ability of financial protection of AD patients' families, and an interaction model between health service utilization and financial protection will be constructed. Based on the results of the analysis, using the expert consultation method, we will put forward the policy suggestion and explore to construct an targeted social service system for AD patients. This study will contrapuntally supply decision support for improving the competence of financial protection of AD families and the work of prevention and control of AD. Ultimately, the study will have a profound impacts on prevention and control of AD and improving the patients' health related qualty of life.

英文关键词： Population aging;Alzheimer's disease;Health service utilization;Financail protection;Multilevel structural equation model