中国低收入人群心脑血管疾病筹款案例的流行病学特征分析

杨海铭; 宋明钰; 肖梦; 赵禹碹; 王月清; 梁玉芹; 胡尧; 沈鹏; 余灿清; 吕筠; 李立明; 孙点剑一

doi:10.16462/j.cnki.zhjbkz.2023.10.010

中国低收入人群心脑血管疾病筹款案例的流行病学特征分析

doi: 10.16462/j.cnki.zhjbkz.2023.10.010

杨海铭¹,
宋明钰¹,
肖梦¹,
赵禹碹¹,
王月清¹,
梁玉芹³,
胡尧³,
沈鹏³,
余灿清^{1, 2},
吕筠^{1, 2},
李立明^{1, 2},
孙点剑一^{1, 2, ,}

1.
北京大学公共卫生学院流行病与卫生统计学系，重大疾病流行病学教育部重点实验室，北京 100191
2.
北京大学公众健康与重大疫情防控战略研究中心，北京 100191
3.
水滴大病研究院，北京 100102

基金项目:

国家重点研发计划 2020YFC2003405

国家自然科学基金 82103920

国家自然科学基金 81941018

详细信息

通讯作者:
孙点剑一，E-mail: dsun1@bjmu.edu.cn

中图分类号: R181.3
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- 被引次数: 0
出版历程
- 收稿日期: 2022-12-02
- 修回日期: 2023-04-28
- 网络出版日期: 2023-10-23
- 刊出日期: 2023-10-10

Epidemiological characteristics of fund-raising cases of cardiovascular and cerebrovascular diseases among low-income population in China

YANG Haiming¹,
SONG Mingyu¹,
XIAO Meng¹,
ZHAO Yuxuan¹,
WANG Yueqing¹,
LIANG Yuqin³,
HU Yao³,
SHEN Peng³,
YU Canqing^{1, 2},
LYU Jun^{1, 2},
LI Liming^{1, 2},
SUN Dianjianyi^{1, 2
, ,}

1.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Key Laboratory of Epidemiology of Major Diseases, Ministry of Education, Beijing 100191, China
2.
Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
3.
Waterdrop Institute of Serious Diseases, Beijing 100102, China

Funds:

National Key Research and Development Program 2020YFC2003405

National Natural Science Foundation of China 82103920

National Natural Science Foundation of China 81941018

More Information

Corresponding author: SUN Dianjianyi, E-mail: dsun1@bjmu.edu.cn

摘要

摘要: 目的描述2018—2020年我国低收入人群心脑血管疾病筹款案例的流行病学分布及其卫生经济学特征。方法数据来源于“水滴筹”互联网服务平台2018—2020年全国发起的心脑血管疾病筹款案例共251 629条。本研究采用χ²检验、趋势χ²检验以及一般线性回归分析描述筹款案例的分布以及筹款金额的差异。结果研究共纳入了251 629项筹款案例，脑血管疾病占80.9%，心血管疾病占19.1%。2018—2020年筹款案例分别为51 292例、92 123例和108 214例，男性患者数目远超过女性患者且65岁以上的老年患者筹款案例占比逐年升高(趋势χ²检验P<0.001)。发起筹款的患者(患者籍贯)更多地集中于经济欠发达和人口较多的省市。2018—2020年心脑血管疾病总筹款金额分别为12.4亿元、20.4亿元和20.5亿元，但单笔筹款金额逐年减少，单笔脑血管疾病筹款金额由2018年的25 248.2元下降到2020年的19 792.4元，心血管疾病由19 386.3元下降到15 220.5元。患者就诊医院所在地经济发达的案例单笔筹款金额较高。结论我国低收入人群心脑血管疾病筹款案例分布存在明显的性别、年龄以及地区差异。女性患者、65岁以上的老年患者以及西部和东北部地区的患者需要更多的帮扶。
- 心脑血管疾病 /
- 性别差异 /
- 地区差异 /
- 低收入人群
Abstract: Objective To describe the characteristics of epidemiology and health economics of fund-raising cases of cardiovascular and cerebrovascular diseases among low-income population in China from 2018 to 2020. Methods The study used data of 251 629 cardiovascular and cerebrovascular diseases fund-raising cases posted on "Waterdrop" online service platform from year 2018 to 2020 in China. The χ² test, χ² test for trend and general linear regression were used to describe the distribution of fund-raising cases and the difference of amount of money raised. Results A total of 251 629 fund-raising cases were included in the study, of which 80.9% was of cerebrovascular diseases, 19.1% was of cardiovascular diseases. There were 51 292 cases in 2018, 92 123 in 2019 and 108 214 in 2020. The number of male patients was more than that of female patients, and the proportion of patients over 65 years old increased faster during the three years (P_trend<0.001). Fund-raising cases was mostly initiated in economically underdeveloped and populous provinces. The total fund-raising amount of "Waterdrop" platform for cardiovascular and cerebrovascular diseases was 1.24 billion yuan, 2.04 billion yuan, and 2.05 billion yuan for 2018, 2019, and 2020, respectively, but money raised for each case decreased over the years. The average money raised for each case decreased from 25 248.2 yuan to 19 792.4 yuan for cerebrovascular diseases, 19 386.3 yuan to 15 220.5 yuan for cardiovascular diseases from 2018 to 2020. The amount of money raised had regional differences, with higher amount for cases in economically developed provinces. Conclusions Significant differences in gender, age and region were observed for the distribution of cardiovascular and cerebrovascular diseases fund-raising cases. Targeted assist of cardiovascular and cerebrovascular diseases treatment is needed for women, the elderly, and patients from western and northeastern provinces in China.
- Cardiovascular and cerebrovascular disease /
- Gender difference /
- Regional difference /
- Low-income population

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图 1 筹款案例就诊医院省份、患者籍贯以及第七次全国人口普查人口数对比

Figure 1. Comparison of the province of hospitals visited by fund-raising cases, patient′s native place and population in the seventh national population census

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表 1 2018—2020年各心脑血管疾病筹款案例数

Table 1. Number of fund-raising cases for cardiovascular and cerebrovascular diseases from 2018 to 2020

疾病名称 Disease name	案例数 Number of cases	百分比/% Percentage/%	ICD-10疾病编码 ICD-10 code
脑血管疾病 Cerebrovascular disease
脑出血 Cerebral hemorrhage	152 827	60.7	I61
脑梗死^① Cerebral infarction ^①	42 618	16.9	I63
脑梗死后遗症 Sequelae of cerebral infarction	1 876	0.8	I69.3
脑/颈动脉闭塞 Cerebral/Carotid occlusion	1 608	0.6	I65
脑动脉瘤破裂出血 Cerebral aneurysm rupture and bleeding	1 588	0.6	I60.7
脑干梗死 Brainstem infarction	1 295	0.5	G46.3
腔隙性脑梗死^② Lacunar infarction ^②	1 774	0.7	I63.81
心血管疾病 Cardiovascular diseases
冠心病^③ Coronary heart disease ^③	31 873	12.7	I20~I25
心衰 Heart failure	9 779	3.9	I50
肺动脉高压 Pulmonary hypertension	2 269	0.9	I27.0
心肌病 Cardiomyopathy	4 122	1.6	I42
合计 Total	251 634	100.0
注：ICD-10, 《国际疾病分类第10版》。 ①脑梗死包括词条：急性脑梗死、大面积脑梗塞、陈旧性脑梗塞。②腔隙性脑梗死包括词条：腔隙性脑梗死、腔隙性脑梗塞。③冠心病包括词条：冠心病、陈旧性心肌梗死。 Note: ICD-10, International Classification of Diseases Version 10. ① Cerebral infarction included: acute cerebral infarction, massive cerebral infarction and old cerebral infarction. ② Lacunar infarction included: lacunar infarction. ③ Coronary heart disease included: coronary heart disease, old myocardial infarction.

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表 2 2018—2020年各心脑血管疾病筹款案例数

Table 2. Number of fund-raising cases for cardiovascular and cerebrovascular diseases from 2018 to 2020

人口学特征 Demographic characteristics	筹款年份 Fund-raising year			P值 value
人口学特征 Demographic characteristics	2018	2019	2020	P值 value
性别^① Gender ^①
男 Men	34 371(67.0)	62 200(67.5)	73 499(67.9)	0.001 ^③
女 Women	16 921(33.0)	29 923(32.5)	34 715(32.1)
年龄/岁^① Age/years ^①
<45	10 911(21.3)	17 647(19.2)	20 988(19.4)	< 0.001 ^③
45~<65	30 873(60.2)	55 247(60.0)	63 419(58.6)
≥65	9 508(18.5)	19 229(20.9)	23 807(22.0)
人口类型^① Population type ^①
劳动人口 Working population	35 031(68.3)	60 883(66.1)	70 638(65.3)	< 0.001 ^③
非劳动人口 Non-working population	16 261(31.7)	31 240(33.9)	37 576(34.7)

人口学特征 Demographic characteristics	筹款年份/年 Fund-raising year/year			P值 value
人口学特征 Demographic characteristics	2018	2019	2020	P值 value
患者籍贯所在地区^① Patient′s native place ^①
华中地区 Central China	11 723(22.9)	20 680(22.4)	23 941(22.1)	< 0.001 ^③
华东地区 East China	11 455(22.3)	20 493(22.2)	22 448(20.7)
西南地区 Southwest	8 317(16.2)	15 076(16.4)	20 677(19.1)
华南地区 South China	4 041(7.9)	10 072(10.9)	14 223(13.1)
华北地区 North China	6 563(12.8)	10 321(11.2)	11 197(10.3)
东北地区 Northeast	4 811(9.4)	8 154(8.9)	7 838(7.2)
西北地区 Northwest	4 382(8.5)	7 327(8.0)	7 890(7.3)
实际筹款金额/元^② Actual fund-raising amount/yuan ^②				< 0.001 ^④
心血管疾病 Cardiovascular disease	19 386(239.0)	17 930(152.8)	15 221(120.6)
脑血管疾病 Cerebrovascular disease	25 249(299.3)	23 142(189.2)	19 792(144.2)
所有疾病 All diseases	24 151(289.9)	22 130(183.3)	18 924(140.5)
注：①括号外数据为筹款案例数，括号内数据为构成比。②括号外数据为平均筹款金额，括号内数据为标准误。③ χ²检验P值。④一般线性回归模型中以所有疾病的实际筹款金额作为因变量分析后得到的年份的趋势检验P值。 Note: ①The data outside and inside the brackets are the number of fund-raising cases, and the proportion, respectively. ②The data outside and inside the brackets are the average fund-raising amount, and the standard error, respectively. ③The P values for Chi-square tests. ④The P value for trend of years was calculated using the general linear regression models with actual fund-raising amount of all diseases being the dependent variable.

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表 3 2018—2020年纳入分析的心脑血管筹款案例地区分布

Table 3. Regional distribution of cardiovascular and cerebrovascular fund-raising cases included in the analysis from 2018 to 2020

地区 Region	案例密度^① Density of cases ^①		总案例数 Total number of cases		心脑血管疾病年龄标化患病率^② Age-standardized prevalence of cardiovascular and cerebrovascular diseases ^②
地区 Region	排名 Rank	案例数/10万^-1 Number of cases/100 000^-1	排名 Rank	案例数/10万^-1 Number of cases/100 000^-1	排名 Rank	案例数/10万^-1 Number of cases/100 000^-1
广西壮族自治区 Guangxi Zhuang Autonomous Region	1	31.8	3	15 956	27	5 460.2
河南省 Henan Province	2	29.3	1	29 073	10	6 378.4
黑龙江省 Heilongjiang Province	3	27.4	15	8 735	3	6 668.8
海南省 Hainan Province	4	26.9	24	2 716	13	6 326.7
陕西省 Shaanxi Province	5	25.9	10	10 220	29	5 365.0
贵州省 Guizhou Province	6	25.6	12	9 854	14	6 270.3
吉林省 Jilin Province	7	24.3	19	5 839	5	6 485.5
山西省 Shanxi Province	8	23.9	16	8 351	7	6 460.5
湖南省 Hunan Province	9	23.6	4	15 673	16	6 103.5
江西省 Jiangxi Province	10	23.5	9	10 637	21	5 935.2
内蒙古自治区 Inner Mongolia Autonomous Region	11	22.8	20	5 484	1	6 878.0
云南省 Yunnan Province	12	21.5	11	10 159	15	6 130.8
甘肃省 Gansu Province	13	21.2	21	5 304	19	6 023.3
重庆市 Chongqing City	14	21.1	17	6 771	17	6 047.7
四川省 Sichuan Province	15	20.4	2	17 106	26	5 473.8
湖北省 Hubei Province	16	20.1	7	11 598	25	5 475.2
安徽省 Anhui Province	17	19.0	8	11 569	24	5 846.9
河北省 Hebei Province	18	17.1	6	12 779	2	6 811.8
青海省 Qinghai Province	19	16.3	27	963	11	6 361.2
宁夏回族自治区 Ningxia Hui Autonomous Region	20	15.2	26	1 093	22	5 929.0
山东省 Shandong Province	21	15.0	5	15 269	18	6 037.3
辽宁省 Liaoning Province	22	14.6	18	6 229	4	6 661.3
江苏省 Jiangsu Province	23	10.3	14	8 761	6	6 470.8
福建省 Fujian Province	24	10.2	22	4 249	28	5 388.5
新疆维吾尔自治区 Xinjiang Uygur Autonomous Region	25	7.8	25	2 019	12	6 335.6
广东省 Guangdong Province	26	7.7	13	9 664	20	5 980.3
天津市 Tianjin City	27	6.0	28	830	8	6 455.6
浙江省 Zhejiang Province	28	5.6	23	3 622	30	5 181.3
西藏自治区 Tibet Autonomous Region	29	4.9	31	180	9	6 410.1
北京市 Beijing City	30	2.9	29	637	23	5 914.6
上海市 Shanghai City	31	1.2	30	289	31	5 075.5
注：①案例密度=各省份(患者籍贯)案例数/第七次全国人口普查该省份人口数^[6]。②数据来源于2016年全球疾病负担研究^[13]。 Note: ①Density of cases=number of cases in each province (patient′s native place)/number of the Seventh National Population Census population of the province ^[6]. ②The data came from the Global Burden of Disease Study in 2016^[13].

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