周脉耕, 杨功焕. 中国人群死亡地点影响因素研究[J]. 疾病监测, 2009, 24(5): 382-385. DOI: 10.3784/j.issn.1003-9961.2009.05.022
引用本文: 周脉耕, 杨功焕. 中国人群死亡地点影响因素研究[J]. 疾病监测, 2009, 24(5): 382-385. DOI: 10.3784/j.issn.1003-9961.2009.05.022
ZHOU Mai-geng, YANG Gong-huan. Factors associated with place of death in China[J]. Disease Surveillance, 2009, 24(5): 382-385. DOI: 10.3784/j.issn.1003-9961.2009.05.022
Citation: ZHOU Mai-geng, YANG Gong-huan. Factors associated with place of death in China[J]. Disease Surveillance, 2009, 24(5): 382-385. DOI: 10.3784/j.issn.1003-9961.2009.05.022

中国人群死亡地点影响因素研究

Factors associated with place of death in China

  • 摘要: 目的探索社会人口学特征、疾病诊断、居住地等因素和患者死亡应地点之间的关系。方法利用全国第三次死因回顾抽样调查的数据,以不同人群特征为自变量,是否死在医院为应变量,进行单因素和多因素分析。结果共有868 484例死亡病例纳入分析,其中医院死亡169 206例,占总死亡的19.48%,家中和其他场所死亡699 278例,占总死亡的80.52%。通过调整其他因素后发现,男性死于医院的IOR/I值为0.960(95%ICI/I:0.948~0.973)。随着年龄的增加,死在医院的可能性降低。教育程度越高,死在医院的可能越大。与已婚者相比,未婚、离异和丧偶者死在医院的可能性低。城市较农村更易于死在医院里(IOR/I=2.092, 95%ICI/I:2.063~2.122)。与工人相比,领导干部和办事人员更易于死在医院中,IOR/I值及其95%ICI/I为1.538 (1.490~ 1.587),而农民更可能死在家中,IOR/I值及其95%为ICI/I为0.196(0.192~ 0.200)。母婴疾病和先天异常死在医院的比例较高(IOR/I=2.501, 95%ICI/I:2.363~2.646),呼吸系统疾病(IOR/I=0.837, 95%ICI/I:0.818~0.855)和精神神经系统疾病(IOR/I=0.515, 95%ICI/I:0.483~ 0.548)死在医院的比例较低,其他疾病死在医院的比例则相差不大。结论社会经济地位较高的人群死在医院的可能较大,母婴疾病与先天异常更易死在医院中,精神和神经系统疾病更易死在家中,中国中部地区的人群死在医院的可能性更大。这些联系应结合当地的文化背景和卫生服务系统情况加以考虑。

     

    Abstract: ObjectiveTo explore the relationship between the death places and the socio-demographic feature, disease diagnosis, and residence area in China. MethodsBy using data from 2004 to 2005 national death survey, univariate and multivariate analysis were conducted to estimate the relationship between each variable and the probability of death in hospital. ResultsIn total, 868 484 death cases were analyzed, including 169 206 (19.48%) deaths in hospital and 699 278 (80.52%) deaths that occurred at home and at other places. The adjusted IOR/I for the death of men in hospital was 0.960 (95%ICI/I: 0.948-0.973).Younger people were more likely to die in hospital, so were married people, people with higher education level, people living in urban area and people in central China. Compared with workers, high-level government officials and clerks were more likely die in hospital (adjusted IOR/I=1.538, 95%ICI/I: 1.490-1.587). Farmers were more likely to die at home or at other places (adjusted IOR/I=0.196, 95%ICI/I: 0.192-0.200). Compared with cancer patients, patients with maternal/perinatal disease and congenital anomalies were more likely to die in hospital (adjusted IOR/I=2.501, 95%ICI/I: 2.363-2.646), whereas patients with psychiatric disorder and nervous system disorder (adjusted IOR/I=0.515, 95%ICI/I: 0.483-0.548) and chronic respiratory disease (adjusted IOR/I=0.837, 95%ICI/I: 0.818-0.855) were less likely to die in hospital. The proportions of deaths in hospital caused by other diseases were approximately the same. ConclusionThe probability of dying in hospital was higher among people with higher socioeconomic status. Patients with maternal/perinatal disease and congenital anomalies were more likely to die in hospital, and patients with psychiatric disorder, nervous system disorder, and chronic lower respiratory disease were less likely to die in hospital. The probability of dying in hospital was higher in central China. These results should be interpreted within the context of the local culture and health care systems.

     

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