Chinese General Practice ›› 2024, Vol. 27 ›› Issue (20): 2505-2511.DOI: 10.12114/j.issn.1007-9572.2023.0614
• Original Research·Multimorbidity Section • Previous Articles Next Articles
Received:
2023-10-10
Revised:
2023-12-20
Published:
2024-07-15
Online:
2024-04-08
Contact:
ZHANG Dan
通讯作者:
张丹
作者简介:
作者贡献:
王萧冉、关新月、张丹提出主要研究目标,负责研究的构思与设计,研究的实施,撰写论文,问卷的发放与回收;王萧冉、关新月进行数据的收集与整理,统计学处理,图、表的绘制与展示;张丹进行论文的修订,负责文章的质量控制与审查,对文章整体负责,监督管理。
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2023.0614
基本特征 | 人数 | 就医延迟 | χ2值 | P值 | 基本特征 | 人数 | 就医延迟 | χ2值 | P值 |
---|---|---|---|---|---|---|---|---|---|
年龄(岁) | 10.495 | 0.005 | 医疗保险类型 | 40.543 | <0.001 | ||||
60~65 | 633 | 142(58.43) | 城镇职工医疗保险 | 664 | 121(49.79) | ||||
66~70 | 304 | 76(31.28) | 城乡居民医疗保险 | 313 | 115(47.33) | ||||
>70 | 61 | 25(10.29) | 其他 | 21 | 7(2.88) | ||||
性别 | 10.426 | 0.001 | 疾病了解程度 | 21.454 | <0.001 | ||||
男 | 518 | 148(60.91) | 了解 | 838 | 181(74.49) | ||||
女 | 480 | 95(39.09) | 不了解 | 160 | 62(25.51) | ||||
文化程度 | 7.539 | 0.006 | 疾病相关自我效能 | 34.821 | <0.001 | ||||
初中及以下 | 220 | 69(28.40) | 高 | 959 | 218(89.71) | ||||
高中及以上 | 778 | 174(71.60) | 低 | 39 | 25(10.29) | ||||
婚姻状态 | 19.768 | <0.001 | 是否签约家庭医生 | 25.576 | <0.001 | ||||
已婚 | 935 | 213(87.65) | 是 | 644 | 124(51.03) | ||||
其他 | 63 | 30(12.35) | 否 | 354 | 119(48.97) | ||||
居住情况 | 17.391 | <0.001 | 患慢性病数量(种) | 0.008 | 0.928 | ||||
独居 | 57 | 27(11.11) | 2 | 359 | 88(36.21) | ||||
非独居 | 941 | 216(88.89) | >2 | 639 | 155(63.79) | ||||
户籍类型 | 5.282 | 0.022 | 患慢性病时间(年) | 1.735 | 0.188 | ||||
城市 | 821 | 188(77.37) | ≤5 | 319 | 86(35.39) | ||||
农村 | 177 | 55(22.63) | >5 | 679 | 157(64.61) | ||||
个人平均年收入(元) | 2.379 | 0.123 | 自评健康状况 | 12.754 | 0.002 | ||||
<50 000 | 528 | 139(57.20) | 好 | 373 | 71(29.22) | ||||
≥50 000 | 470 | 104(42.80) | 一般 | 489 | 143(58.85) | ||||
差 | 136 | 29(11.93) |
Table 1 Characteristics of patient delay in older adults with multimorbidity
基本特征 | 人数 | 就医延迟 | χ2值 | P值 | 基本特征 | 人数 | 就医延迟 | χ2值 | P值 |
---|---|---|---|---|---|---|---|---|---|
年龄(岁) | 10.495 | 0.005 | 医疗保险类型 | 40.543 | <0.001 | ||||
60~65 | 633 | 142(58.43) | 城镇职工医疗保险 | 664 | 121(49.79) | ||||
66~70 | 304 | 76(31.28) | 城乡居民医疗保险 | 313 | 115(47.33) | ||||
>70 | 61 | 25(10.29) | 其他 | 21 | 7(2.88) | ||||
性别 | 10.426 | 0.001 | 疾病了解程度 | 21.454 | <0.001 | ||||
男 | 518 | 148(60.91) | 了解 | 838 | 181(74.49) | ||||
女 | 480 | 95(39.09) | 不了解 | 160 | 62(25.51) | ||||
文化程度 | 7.539 | 0.006 | 疾病相关自我效能 | 34.821 | <0.001 | ||||
初中及以下 | 220 | 69(28.40) | 高 | 959 | 218(89.71) | ||||
高中及以上 | 778 | 174(71.60) | 低 | 39 | 25(10.29) | ||||
婚姻状态 | 19.768 | <0.001 | 是否签约家庭医生 | 25.576 | <0.001 | ||||
已婚 | 935 | 213(87.65) | 是 | 644 | 124(51.03) | ||||
其他 | 63 | 30(12.35) | 否 | 354 | 119(48.97) | ||||
居住情况 | 17.391 | <0.001 | 患慢性病数量(种) | 0.008 | 0.928 | ||||
独居 | 57 | 27(11.11) | 2 | 359 | 88(36.21) | ||||
非独居 | 941 | 216(88.89) | >2 | 639 | 155(63.79) | ||||
户籍类型 | 5.282 | 0.022 | 患慢性病时间(年) | 1.735 | 0.188 | ||||
城市 | 821 | 188(77.37) | ≤5 | 319 | 86(35.39) | ||||
农村 | 177 | 55(22.63) | >5 | 679 | 157(64.61) | ||||
个人平均年收入(元) | 2.379 | 0.123 | 自评健康状况 | 12.754 | 0.002 | ||||
<50 000 | 528 | 139(57.20) | 好 | 373 | 71(29.22) | ||||
≥50 000 | 470 | 104(42.80) | 一般 | 489 | 143(58.85) | ||||
差 | 136 | 29(11.93) |
变量 | β | SE | Wald χ2值 | P值 | OR | 95%CI |
---|---|---|---|---|---|---|
年龄(以60~65岁为对照) | ||||||
66~70岁 | 0.017 | 0.178 | 0.009 | 0.923 | 1.017 | (0.718~1.441) |
>70岁 | 0.538 | 0.313 | 2.944 | 0.086 | 1.712 | (0.926~3.164) |
性别(以男性为对照) | ||||||
女性 | -0.355 | 0.169 | 4.408 | 0.036 | 0.701 | (0.504,0.977) |
文化程度(以初中及以下为对照) | ||||||
高中及以上 | -0.282 | 0.195 | 2.083 | 0.149 | 0.754 | (0.515~1.106) |
婚姻状况(以已婚为对照) | ||||||
其他 | 0.480 | 0.358 | 1.791 | 0.181 | 1.616 | (0.800~3.261) |
居住情况(以独居为对照) | ||||||
非独居 | -0.447 | 0.377 | 1.402 | 0.236 | 0.640 | (0.305~1.340) |
户籍类型(以城市为对照) | ||||||
农村 | -0.528 | 0.255 | 4.277 | 0.039 | 0.590 | (0.358~0.973) |
医疗保险类型(以城镇职工医疗保险为对照) | ||||||
城乡居民医疗保险 | 0.978 | 0.210 | 21.799 | <0.001 | 2.660 | (1.764~4.010) |
其他 | 0.944 | 0.569 | 2.754 | 0.097 | 2.570 | (0.843~7.837) |
疾病了解程度(以了解为对照) | ||||||
不了解 | 0.374 | 0.219 | 2.925 | 0.087 | 1.454 | (0.947~2.232) |
疾病相关自我效能(以高为对照) | ||||||
低 | 1.477 | 0.380 | 15.112 | <0.001 | 4.378 | (2.079~9.217) |
是否签约家庭医生(以是为对照) | ||||||
否 | 0.823 | 0.174 | 22.250 | <0.001 | 2.277 | (1.618~3.206) |
自评健康状况(以好为对照) | ||||||
一般 | 0.441 | 0.189 | 5.436 | 0.020 | 1.554 | (1.073~2.250) |
差 | -0.237 | 0.292 | 0.659 | 0.417 | 0.789 | (0.445~1.398) |
Table 2 Multivariate Logistic regression analysis on patient delay in older adults with multimorbidity
变量 | β | SE | Wald χ2值 | P值 | OR | 95%CI |
---|---|---|---|---|---|---|
年龄(以60~65岁为对照) | ||||||
66~70岁 | 0.017 | 0.178 | 0.009 | 0.923 | 1.017 | (0.718~1.441) |
>70岁 | 0.538 | 0.313 | 2.944 | 0.086 | 1.712 | (0.926~3.164) |
性别(以男性为对照) | ||||||
女性 | -0.355 | 0.169 | 4.408 | 0.036 | 0.701 | (0.504,0.977) |
文化程度(以初中及以下为对照) | ||||||
高中及以上 | -0.282 | 0.195 | 2.083 | 0.149 | 0.754 | (0.515~1.106) |
婚姻状况(以已婚为对照) | ||||||
其他 | 0.480 | 0.358 | 1.791 | 0.181 | 1.616 | (0.800~3.261) |
居住情况(以独居为对照) | ||||||
非独居 | -0.447 | 0.377 | 1.402 | 0.236 | 0.640 | (0.305~1.340) |
户籍类型(以城市为对照) | ||||||
农村 | -0.528 | 0.255 | 4.277 | 0.039 | 0.590 | (0.358~0.973) |
医疗保险类型(以城镇职工医疗保险为对照) | ||||||
城乡居民医疗保险 | 0.978 | 0.210 | 21.799 | <0.001 | 2.660 | (1.764~4.010) |
其他 | 0.944 | 0.569 | 2.754 | 0.097 | 2.570 | (0.843~7.837) |
疾病了解程度(以了解为对照) | ||||||
不了解 | 0.374 | 0.219 | 2.925 | 0.087 | 1.454 | (0.947~2.232) |
疾病相关自我效能(以高为对照) | ||||||
低 | 1.477 | 0.380 | 15.112 | <0.001 | 4.378 | (2.079~9.217) |
是否签约家庭医生(以是为对照) | ||||||
否 | 0.823 | 0.174 | 22.250 | <0.001 | 2.277 | (1.618~3.206) |
自评健康状况(以好为对照) | ||||||
一般 | 0.441 | 0.189 | 5.436 | 0.020 | 1.554 | (1.073~2.250) |
差 | -0.237 | 0.292 | 0.659 | 0.417 | 0.789 | (0.445~1.398) |
模型 | AUC | 95%CI | SE | 灵敏度 | 特异度 | P值 |
---|---|---|---|---|---|---|
多因素Logistic | 0.729 | 0.692~0.767 | 0.019 | 69.5% | 69.5% | <0.001 |
分类决策树 | 0.721 | 0.685~0.757 | 0.018 | 74.1% | 60.7% | <0.001 |
Table 3 Comparison of the predictive effectiveness of multivariate Logistic regression model and decision tree model for patient delay in older adults with multimorbidity
模型 | AUC | 95%CI | SE | 灵敏度 | 特异度 | P值 |
---|---|---|---|---|---|---|
多因素Logistic | 0.729 | 0.692~0.767 | 0.019 | 69.5% | 69.5% | <0.001 |
分类决策树 | 0.721 | 0.685~0.757 | 0.018 | 74.1% | 60.7% | <0.001 |
Figure 2 ROC curve of multivariate Logistic regression and decision tree model based on CHAID algorithm for predicting patient delay in older adults with multimorbidity
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