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印度老年人的未治疗发病率及就医行为:基于2004年和2014年全国抽样调查的分析

Untreated morbidity and treatment-seeking behaviour among the elderly in India: Analysis based on National Sample Survey 2004 and 2014.

作者信息

Srivastava Shobhit, Gill Anayat

机构信息

International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, India.

Centre for Research in Rural and Industrial Development, Sector 19, Chandigarh, India.

出版信息

SSM Popul Health. 2020 Feb 9;10:100557. doi: 10.1016/j.ssmph.2020.100557. eCollection 2020 Apr.

Abstract

The changing demographic structure in India and worldwide accompanies with it a gamut of problems and opportunities. According to the Census of India, the proportion of elderly in the overall population rose from 5.6 per cent in 1961 to 8.6 per cent in 2011 and is expected to rise to 20 per cent in 2050. Considering the consequent growing challenges in healthcare the main aim of the study is to find essential determinants contributing to untreated morbidity among the elderly. Also, the paper examines treatment-seeking behaviour for infectious and chronic diseases among the elderly in India. Data from the 60th and 71st round of National Sample Survey Organization was used for the analysis. Relative differences were calculated along with logistic regression to study the objectives and the heckprobit model was used to carve out the treatment-seeking behaviour among the elderly in India. It was found that the overall decrease in relative decadal difference was 41% for untreated morbidity. In both the rounds, the elderly living below the poverty line had 42% and 50% more likelihood of untreated morbidities respectively in comparison to elderly not living below the poverty line. The study indicates that elderly who were living with a spouse in comparison to those living alone had less likelihood to have untreated morbidities. Also, elderly from rural areas and having lower levels of education had higher likelihood of untreated morbidity. Similar inequalities were observed in treatment-seeking behaviour as well, where it was found that elderly belonging to lower socio-economic status were less likely to seek treatment. Linking the results from the heckprobit model this study provides the evidence that social and economic factors play a significant role in affecting both untreated morbidity and treatment-seeking behaviour of elderly in India.

摘要

印度及全球人口结构的变化带来了一系列问题和机遇。根据印度人口普查,老年人口在总人口中的比例从1961年的5.6%上升到2011年的8.6%,预计到2050年将升至20%。考虑到随之而来的医疗保健方面日益增长的挑战,该研究的主要目的是找出导致老年人未治疗疾病的关键决定因素。此外,本文还研究了印度老年人针对传染病和慢性病的就医行为。分析使用了全国抽样调查组织第60轮和第71轮的数据。计算了相对差异并进行逻辑回归以研究目标,同时使用heckprobit模型来剖析印度老年人的就医行为。研究发现,未治疗疾病的相对十年差异总体下降了41%。在这两轮调查中,与未生活在贫困线以下的老年人相比,生活在贫困线以下的老年人未治疗疾病的可能性分别高出42%和50%。研究表明,与独居的老年人相比,有配偶陪伴的老年人未治疗疾病的可能性较小。此外,农村地区且受教育程度较低的老年人未治疗疾病的可能性较高。在就医行为方面也观察到了类似的不平等现象,发现社会经济地位较低的老年人就医的可能性较小。结合heckprobit模型的结果,本研究提供了证据,证明社会和经济因素在影响印度老年人未治疗疾病和就医行为方面发挥着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/197d/7109628/4a8323713981/gr1.jpg

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