Research On Risk Index System Of Rural Old People's Health And Poverty Vulnerability

[Purpose] Clarify the connotation and characteristics of health poverty and health poverty vulnerability,distinguish and link,explore the multi-dimensional risk factors of poverty-stricken poverty;build an evaluation index system based on the capacity deprivation perspective,and measure the health and poverty vulnerability of rural elderly Sexual risk,using statistical analysis methods to identify the relationship between healthy and vulnerable vulnerable populations and indicators of health and poverty vulnerability characteristics,to construct key characteristics of healthy and vulnerable populations,and provide a theoretical reference for accurately identifying healthy and poor population.[Methods](1)Literature analysisDocument retrieval is carried out by means of literature retrospective method.Risk factors of poverty and health poverty,evaluation methods of health poverty,supply and utilization of health services,status and effectiveness of medical security,poverty vulnerability,poverty alleviation related theoretical research and implementation status of poverty strategies are systematically consulted.On this basis,the method of word frequency analysis is used to screen the health poverty-related risk assessment indicators in the literature,and the multi-dimensional poverty-related risk index database of health poverty vulnerability is preliminarily established.(2)Expert Discussion Method14 outstanding young and middle-aged scholars who have been engaged in health management,health economics and rural health have been invited to hold a special seminar to fully evaluate the importance,sensitivity,operability and evaluation criteria of the multi-dimensional risk indicators selected by the literature.discuss.Combined with the experts' suggestions,the indicators in the risk database were expanded,and the unscientific and operability indicators were eliminated,and the first draft of the health poverty vulnerability risk index system was formed,which was used as the basis for the first round of expert consultation questionnaire.(3)Delphi methodOn the basis of the expert seminar to form a healthy and vulnerable vulnerability index system,the Delphi method is used to screen the evaluation dimension of health poverty vulnerability and the risk of poverty alleviation.After two rounds of expert opinions collection,modification and feedback,rural elderly are constructed.Human health poverty vulnerability risk indicator system.(4)On-site investigation methodA multi-stage stratified random sampling method was adopted.Four counties in Hubei Province(Xianfeng County,Badong County),Guizhou Province(Zheng'an County,Fenggang County)and two provinces were selected as sample counties.450 poor and 450 non-poor households were randomly selected from each county for household survey.A total of 1852 rural elderly households were surveyed,including 914 households in Hubei Province and 938 households in Guizhou Province.Among them,796 were poor households and 1058 were non-poor households,including 5269 rural residents.(5)Statistical methodsThis paper summarizes the risk factors of health poverty vulnerability by word frequency analysis,describes the basic characteristics of the research objects and index system by descriptive statistics,calculates the distribution characteristics of health poverty vulnerability of the sample families by using the method of anticipated poverty vulnerability calculation,and constructs a discriminant function to judge the health poverty vulnerability of the elderly families by using Fisher discriminant analysis method.[Results](1)To clarify the connotation,characteristics,differences and links between health poverty and health poverty vulnerability: health poverty originates from the lag of economic development,the lack of participation in medical security and health care,and the lack of public health services caused by the imperfect social security system,and the decline of income-earning ability caused by health problems,leading to the occurrence or aggravation of poverty.Health poverty is affected by a variety of risk factors,with dynamic and sustainable characteristics.Vulnerability to health poverty is the possibility that health-related risk shocks will lead to the decline of family or individual welfare below the poverty line,which is forward-looking and reflects the probability of poverty in the future.The vulnerability of health poverty is an advance measure of health poverty.The higher the vulnerability,the higher the probability of families falling into health poverty in the future.(2)Based on the perspective of capacity deprivation,eight secondary indicators including family health deprivation risk,health economic risk and risk coping ability were constructed,including family deprivation depth risk,deprivation persistent risk,utilization of medical services,direct disease burden,indirect disease burden,family coping ability,coping ability of medical insurance system and social support.The target health poverty vulnerability index system.(3)Distribution characteristics of health poverty vulnerability indicators in sample families: the average proportion of chronic disease patients in sample families is 0.68,the median is 0.69,of which 1 235 families have chronic disease patients whose proportion is more than 0.5,accounting for 74.12% of the respondents;members of 582 families have physical disability,accounting for 35.21% of the respondents;the average annual rate of family disease adjustment is 18.86 years,the mode is 12 years;the average number of actual hospitalization days per capita is 6.8 days,with a median of 2.8 days.There are 1001 families with hospitalization in one year,accounting for 60.56%;21 families with hospitalization but not hospitalization,accounting for 1.27%;851 families with family medical expenditure greater than 40%,accounting for 51.48%;6 families with more than 60% have hospitalization.Thirty households accounted for 38.11%;548 households(33.15%)had annual per capita health expenditure and regional per capita disposable income ratio of 0.5;198 households(11.98%)had lost their labor force.According to the combination of poverty vulnerability index and income standard,1653 rural elderly families were divided into poverty-stricken families,temporary poverty-stricken families,potential poverty-stricken families and non-poverty families.There were 455 families,265 families,492 families and 441 families,accounting for 27.53%,16.03%,29.76% and 26.68% respectively.On the basis of the survey data,four functions to distinguish the type of rural elderly families are constructed by discriminant analysis.With the data of each index obtained from the survey,the discriminant function can be used to judge and identify the vulnerability of health poverty.After sorting out the household data,they are substituted into the functional equation separately,and the corresponding type of the maximum value of Y value of the discriminant function,i.e.the health poverty vulnerability state of the household,is identified.[Conclusions](1)Disease and poverty are mutually causal.Disease,on the one hand,brings huge economic burden to families by increasing the expenditure of family medical expenses.On the other hand,disease will cause the decline of individual labor ability and the ability to create income.Seriously,it will cause the loss of labor ability.When the expenditure of medical expenses exceeds the family income and the ability of family income decreases,it will fall into poverty.However,poor families have lost the opportunity to participate in medical security,health care services and access to high-quality medical services due to the limitation of their ability to pay,resulting in a decline in health status and the occurrence or aggravation of diseases.(2)Different types of families have different vulnerabilities and poverty-causing factors,which need to be classified accurately and put into practice.Families trapped in poverty,temporarily impoverished families,potential impoverished families and non-impoverished families have different risk characteristics.The factors leading to poverty vulnerability vary in size and size.For poor families,poverty vulnerability is relatively high.These groups belong to deep poverty,and it is difficult to return to poverty.For these groups,we must find out the deep-seated reasons why families fall into poverty,stimulate family motivation and create sustainable income sources for families,in order to get rid of poverty completely;for temporary poor families,we must find out the deep-seated reasons why families fall into poverty.Families are poor according to the current poverty line standards,but their vulnerability is very small,and they will soon get rid of poverty.For potential poor families,family poverty vulnerability is high,and need to intervene and help strategies in advance to avoid falling into poverty.[Innovations](1)Based on the perspective of capacity deprivation,this study constructs a multi-dimensional risk index system for health poverty vulnerability of rural elderly from multi-dimensional and multi-angle.(2)Combining poverty vulnerability index and household income,this study divides the rural elderly into four categories: poverty-stricken,temporary poverty,potential poverty and non-poverty groups.On this basis,the risk factors are discriminated and analyzed to provide the basis for the follow-up precise poverty alleviation.…….[Limitations](1)Using the Barthel Index Rating Scale to assess the disability of rural elderly in the questionnaire may underestimate the real situation of rural disabled population.(2)Survey data are retrospective data,which may be disturbed by recall bias and deviate from the actual situation.(3)Representing the number of family members with the number of households in the family may result in the inconsistency of family relationships in economic relations and residential relationships,which leads to deviations in the information on household income and expenditure.