Study On The Influencing Factors And Decomposition Of Health Inequality Of Patients With Chronic Diseases From The Perspective Of Drug Welfare

Objective:Chronic diseases have had a significant economic impact on society,families and individuals,and have significantly reduced the quality of life of patients.In the case of impaired health of patients with chronic diseases,long-term medication is required,and the health level of patients with chronic diseases is affected by various factors such as drug policies,income,and psychology.Based on the perspective of drug welfare,this study uses data from chronic disease patients in the five research areas of Gansu,Hebei,Sichuan,Zhejiang,and Tianjin to analyze the inequality of chronic disease patients’ urban-rural health and regional health.Methods To find out the influencing factors of health inequality in patients with chronic diseases,and to decompose the influencing factors of health inequality,and finally put forward countermeasures and suggestions based on the empirical results to improve the health of patients with chronic diseases,narrow the health gap,and improve the welfare of drugs.Methods:Based on literature analysis,Citespace visualized knowledge maps were used to visually show the research hotspots and progress in the field of health unequal research at home and abroad.The Chinese version EQ-5D-5L scale was used to calculate the health effect value of patients with chronic diseases,and to measure and evaluate the health status of the study subjects.Tobit regression model was used to find out the influencing factors of chronic disease patients’health inequality from the four aspects of chronic disease patients’ basic characteristics,drug accessibility,drug price situation,and drug equity situation,and then use the centralized index decomposition method for urban and rural and interregional chronic disease patients’ health Influencing factors of inequality are decomposed to find out the contribution of these influencing factors to the health inequality of patients with chronic diseases.Results:(1)Research on the influencing factors of health inequality of chronic disease patients from the perspective of drug welfare:after Tobit regression on the health level of chronic disease patients in Gansu,Hebei,Sichuan,Zhejiang and Tianjin,it found the region,hukou,gender,BMI,marriage,education level,Occupation,income,medical insurance,health checkup,the number of medical institutions that can be reached within 15 minutes,the rationality of the proportion of drug expenditures in the family’s disposable income,the rationality of the drug costs of physical pharmacies,the rationality of the proportion of hospitalization costs,and the level of affordability have a significant impact on health.The influencing factors for the health inequality of urban and rural chronic disease patients are age,marriage,education,income,medical insurance,the proportion of family medical disposable income,the rationality of drug expenditures,the rationality of drug costs in physical pharmacies,and the proportion of hospitalization costs.The influencing factors of health inequality of patients with chronic diseases in the east and west include age,marriage,income,education level,rationality of the proportion of drug expenditure in household disposable income,rationality of drug costs in physical pharmacies,and drug burden.(2)Structural decomposition research on health inequality of chronic disease patients from the perspective of drug welfare:the health concentration index of urban chronic disease patients is 0.027 less than the health concentration index of rural chronic disease patients 0.049,age has the largest effect on the health inequality of urban and rural chronic disease patients,and the contribution rate 30.52%and 20.64%respectively,followed by a contribution rate of more than 3,000 yuan to the health inequality of urban and rural chronic disease patients,respectively 29.1%and 19.32%,education level also exacerbates the health inequality of urban and rural chronic diseases at different levels,Medical insurance can reduce the gap in health inequality between urban and rural chronic disease patients;the health concentration index of chronic disease patients in the eastern region is 0.024 higher than that of the western region,and the contribution rate of chronic disease patients in the east and west is 20.58%and 18.53%,respectively.The educational level of high school education and above contributes 59.5%and 11.52%to the health inequality of patients with chronic diseases in the east and the west,respectively.Secondly,followed by income also aggravating the health inequality of patients with chronic diseases in the east and the west,with contribution rates reaching 27.6%and 23.64%respectively.The drug burden also has a certain impact on the health inequality between the east and the west,and it plays a role in widening the health inequality of the poor.The contribution of the rationality of drug expenditure to household disposable income and the rationality of the drug cost of physical pharmacies are very low.The concentration index of these two factors is negative,indicating that these factors can play a role in narrowing the bias of the rich and the poor in chronic diseases.Conclusion:According to the results of the study,patients with chronic diseases in Gansu,Hebei,Sichuan,Zhejiang and Tianjin all have obvious health inequalities between urban and rural areas and between the east and the west.Therefore,suggestions should be made to increase support for poor chronic disease groups and improve the old-age security system;take different measures to improve health levels for chronic disease patients in urban and rural areas;attach importance to health education and psychological counseling for chronic disease patients,and spread health-related knowledge;improve the price mechanism of medicine and strengthen the guarantee mechanism of cheap medicine supply to ensure the accessibility of medicine and medical service.