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中国老年人的死亡质量:医疗支出与及时就医的作用。

Quality of death among older adults in China: The role of medical expenditure and timely medical treatment.

作者信息

Gong Xiuquan, Pei Yaolin, Zhang Min, Wu Bei

机构信息

Professor, Social Science and Public Administration, East China University of Science and Technology, Shanghai, China.

Research Scientist. Rory Meyers College of Nursing, New York University, NY, USA.

出版信息

J Aging Soc Policy. 2023 Sep 3;35(5):667-682. doi: 10.1080/08959420.2022.2079907. Epub 2022 May 24.

Abstract

Medical expenses in the last year of life consume a large portion of healthcare expenditures, yet little is known about the relationship between medical expenditures in the last year of life and quality of death. Few empirical studies have investigated the association between timely medical treatment before dying and quality of death. This study aimed to examine the associations between medical expenditures in the last year of life, timely medical treatment before dying, and quality of death. Data derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the largest national representative study of the oldest-old in China. Results from multinomial logistic regression suggested that higher medical expenses in the last year of life and lack of timely medical treatment before dying are associated with lower quality of death. These findings highlight an urgent need for strengthening education on death and dying, developing hospice and palliative care services, and improving pain management at the end of life in China.

摘要

生命最后一年的医疗费用占医疗保健支出的很大一部分,但对于生命最后一年的医疗支出与死亡质量之间的关系却知之甚少。很少有实证研究调查临终前及时治疗与死亡质量之间的关联。本研究旨在探讨生命最后一年的医疗支出、临终前及时治疗与死亡质量之间的关联。数据来源于中国老年健康影响因素跟踪调查(CLHLS),这是中国规模最大的针对高龄老人的全国代表性研究。多项逻辑回归结果表明,生命最后一年较高的医疗费用以及临终前缺乏及时治疗与较低的死亡质量相关。这些发现凸显出中国迫切需要加强关于死亡和临终的教育,发展临终关怀和姑息治疗服务,并改善临终时的疼痛管理。

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