中国居民健康相关生命质量评价研究

With the rapid development of healthy mode change and the aging of the population, the increasing prevalence of chronic non-communicable diseases and mental pressuredegenerative and/or lifestyle-related chronic diseases have been becoming an important health problem in China. More and more people are pursuing not only live longer, but live well, and assessment on health-relate quality of life has become an essential role of health status evaluation. This research will use data from fifth National Health Service Survey (Start in June 2013) and a supplemental survey including 6000 people from 10 sampled counties to finalize Evaluation Standards of Health-related Quality of Life (ESHQL) in china, with applying VAS and TTO methods. Also, the research will assess health related quality of life of Chinese residents through ESHQL, explore the impact of major chronic diseases, identify some chronic diseases which have greatest influence on health-relate quality of life across different regions and age groups, address the relationship between health-relate quality of life and health service utilization, provide strong evidences for developing chronic disease intervention strategies and health resources long-term allocation mechanism. The research findings will also seeks to demonstrate health status change due to China Healthcare System Reform.

随着健康模式转变以及人口老龄化的迅速发展，慢性非传染性疾病患病率增加，精神疾患增加，退行性疾病及与生活方式相关疾病成为威胁我国居民的主要健康问题。人们在追求长寿的同时也越来越关注生命的质量。本研究一方面利用第五次国家卫生服务调查数据，另一方面选取10个县约6000人开展补充调查，通过视觉模拟标尺（VAS）法和时间权衡法(TTO)确定中国健康相关生命质量评价标准，并评价中国居民健康相关生命质量，分析部分慢性病对健康相关生命质量的影响，确定对不同地区、年龄组人口影响最大的慢性病，探索健康相关生命质量与卫生服务利用之间的关系，为制定慢性病干预措施，合理配置卫生资源提供依据，研究结果也将反映医改实施以来居民健康水平的变化。

本项目在广泛的文献检索、综述的基础上，综合利用两次国家卫生服务调查、TTO（时间权衡法）现场调查数据、慢性病患者健康相关生命质量追踪调查等多来源数据，采用TTO法（时间权衡法）和VAS法（视觉模拟标尺法）法建立中国居民健康相关生命质量的效用值体系，并对两种方法的分析结果从模型拟合、敏感性等方面进行了比较，确定了现阶段的适用的效用值体系。并以此为基础，从5维度健康测量、自评健康状况以及通过效用值体系建立的综合健康评分，对中国居民的健康状况以及在地区、人群中的差异和公平性及其变化开展了深入分析；通过探索慢性病健康相关生命质量追踪调查的方法，定量评估不同慢性病对健康相关生命质量的影响，为完善国家卫生信息系统，制定和调整国家卫生政策提供了依据。