基于Blinder-Oaxaca分解法的城乡T2DM住院患者健康状况差异比较

Comparison of Health Status of Inpatients with Type 2 Diabetes Mellitus between Urban and Rural Areas Based on Blinder-Oaxaca Decomposition

张文玲; 张静; 田小丽; 孙仙; 李金霞

目的 了解城乡2型糖尿病（T2DM）住院患者健康状况及城乡差异，定量分析城乡差异的主要原因，为缩小城乡T2DM住院患者健康状况差异，提供理论依据。方法 采用健康状况测量量表EQ-5D-5L中文版调查城乡T2DM住院患者健康状况，并通过Blinder-Oaxaca分解法分析城乡T2DM住院患者健康状况差异的 原因。结果 城市住院患者EQ-5D-5L指数得分(0.8±0.2)高于农村住院患者指数得分（0.7±0.2），差异具有统计学意义（P<0.001）。多元线性逐步回归分析结果显示，健康状况的影响因素为年龄、个人月收入、现居住地、饮酒、体育锻炼、并发症数量、有无皮肤病变以及进一年住院次数。Blinder-Oaxaca分解结果显示，总体差异中禀赋差异和系数差异分别占76.136%和23.864%，现居住地和个人月收入对城乡T2DM住院患者健康状况的差异有统计学意义，贡献率达35.227%和30.682%。 结论 城市T2DM住院患者健康状况高于农村住院患者，现居住地和个人月收入是造成差异的主要原因。

Objective To compare the health status of inpatients with type 2 diabetes mellitus (T2DM) in urban and rural areas, and to quantitatively analyze the main causes of the differences in health status  between urban and rural areas, so as to provide theoretical basis for narrowing the differences in health status of patients with T2DM in urban and rural areas. Methods The Chinese version of EQ-5D-5L was used to investigate the health status of inpatients with T2DM in urban and rural areas. Blinder-Oaxaca decomposition method was used to analyze the difference in health status of hospitalized patients with T2DM in urban and rural areas.  Results The EQ-5D-5L index score of urban inpatients (0.8±0.2) was significantly higher than that of rural inpatients (0.7±0.2) (P<0.001). The results of multiple linear stepwise regression analysis showed that the influencing factors of the health status of T2DM inpatients were age, personal month, current residence, drinking, physical exercise, presence or absence of complications, presence or absence of skin lesions and the number of hospitalizations in one year. Blinder-Oaxaca decomposition results show that endowment difference and coefficient difference account for 76.136% and 23.864% respectively in the overall difference. The current residence and personal monthly income were significantly associated with the difference in health status between urban and rural T2DM inpatients with the contribution rates of 35.227% and 30.682%, respectively. Conclusion The health status of urban T2DM inpatients is higher than rural inpatients. The main reason for the difference is the current residence and personal monthly income