黑龙江省城镇和农村居民健康相关生命质量的公平性研究OA

Objective To assess the degree of economic-related inequity in health-related quality of life(HRQoL)among urban and rural residents in Heilongjiang Province,and to provide evidence-based basis for improving regional health equity.Methods Based on the data from the 7th National Health Service Survey in Heilongjiang Province,EQ-5D-5L health utility values were used as the outcome indicator.Concentration index(CI)and horizontal inequity(HI)were calculated to systematically analyze the economic-related health inequity among urban and rural residents.Additionally,Tobit model was employed to decompose CI,aiming to explore the contribution of variables such as individual characteristics,health behaviors,and situational characteristics to health inequity.Results The overall EQ-5D-5L health utility value of urban and rural residents in Heilongjiang Province was 0.933,with 0.970 for urban residents and 0.896 for rural residents.The CI of health utility value stood at 0.028(0.007 for urban areas and 0.031 for rural areas),and the HI was 0.031(0.008 for urban areas and 0.033 for rural areas).Tobit model decomposition indicated that age,marital status,employment status,hypertension,physical exercise,and educational level were the main factors affecting HRQoL equity,with contribution rates of-12.86%,11.08%,-7.03%,-6.94%,5.03%,and 4.67%to health inequity,respectively.Conclusions The health equity of HRQoL among urban and rural residents in Heilongjiang Province is relatively favorable,yet it still leans toward populations with higher economic status.It is suggested to construct a multi-dimensional collaborative governance system and optimize systematic mechanisms to comprehensively improve residents'HRQoL and promote the precise realization of health equity.