A Comparative Study On The Changing Trends And Influencing Factors Of The Economic Burden Of Disease Among The Middle-aged And Elderly People In Urban And Rural Areas

Objective:To understand the changing trend of economic burden of disease of middle-aged and elderly people in urban and rural areas in China,to explore the influencing factors of economic burden of disease of middle-aged and elderly people in urban and rural areas in China,and to compare the similarities and differences of influencing factors between urban and rural areas,in order to alleviate the economic burden of disease of middle-aged and elderly people in urban and rural areas,improve the urban and rural medical system,and promote the physical and mental health of middle-aged and elderly people.Methods:Nonparametric tests were used to compare the differences of economic burden of disease under health factors,economic factors,medical insurance factors and informal social support factors in urban and rural areas.The two-way fixed effect model was used to explore the differences of disease economic burden between urban and rural areas,and multiple linear regression was used to fit the effects of various factors on economic burden of disease.Results:From 2011 to 2015,the proportion of middle-aged and elderly people in urban and rural areas with economic burden of disease increased from about 55%to over 60%,and the economic burden of disease increased in both urban and rural areas.In the analysis of influencing factors,the economic burden of disease of self-reported health "bad" in urban area is 5,332 yuan higher on average than that of "very good"(F=20.95,P<0.0001),the economic burden of disease of self-reported health "very bad" is 5.078 yuan higher on average than that of "very good"(F=4.95.P=0.0262),and the economic burden of disease increases 585yuan on average for each increase in the number of chronic diseases(F=9.52,P=0.0021),the economic burden of disease of the patients without medical treatment is 4.967yuan less on average than that of the patients(F=61.64.P<0.0001),the economic burden of disease of retired workers is 2373 yuan higher on average than that of farmers(F=9.12,P=0.0026),the economic burden of disease of professionals(including employees of enterprises and institutions,non-profit organizations,self production and operation activities,etc.)is 2028 yuan higher on average than that of farmers(F=8.40.P=0.0038),the economic burden of disease of medical insurance for urban residents is 1,343 yuan less on average than that of medical insurance for urban workers(F=4.03,P=0.0448).The economic burden of disease self-reported health "bad" in rural area is 3,919 yuan higher on average than that of "good"(F=25.93.P<0.0001),the economic burden of disease of self-reported health "very bad" is 5,393 yuan higher on average than that of "good"(F=19.91,P<0.0001).the economic burden of disease increases 381 yuan on average with each increase of chronic diseases(F=8.23.P=0.0041),the economic burden of disease of professionals(including employees of enterprises and institutions,non-profit organizations,self production and operation activities,etc.)is 994 yuan higher on average than that of farmers(F=5.22,P=0.0223),and the economic burden of disease increased by 334 yuan on average with each increase of family members(F=7.94,P=0.0048).Conclusion:The economic burden of disease of the middle-aged and elderly people in urban and rural areas is on the rise,and the economic burden of disease in urban areas is higher than that in rural areas.Health factors are important factors that affect the economic burden of disease in urban and rural areas.There are obvious differences in economic burden of disease between different health conditions,and chronic diseases are also a major cause of economic burden of disease.The differences between the influcing factors in urban and rural areas are reflected in the disease economic burden of medical insurance for urban workers is higher than medical insurance for urban residents,and the economic burden of disease of urban low-income group is lower than that of high-income group.The increase of family size will cause the increase of economic burden of disease of rural middle-aged and elderly people.We should strengthen the health concept of the middle-aged and the elderly,help them to form a scientific lifestyle;give full play to the advantages of traditional Chinese medicine in the prevention and treatment of disease,promote the popularity of traditional Chinese medicine services;improve the accessibility of medical and health services for low-income groups.establish a disaster response mechanism for health expenditure for low-income groups:To coordinate the role of medical insurance for urban workers and medical insurance for urban residents in coordinating major diseases of the middle-aged and the elderly.and to reduce the difference between the two medical insurance systems in reducing the economic burden of diseases;In order to promote the physical and mental health of the middle-aged and the elderly,we should coordinate the organization within the family and implement two-way intergenerational support.