In the post-poverty alleviation era, in-depth research on the health poverty vulnerability of chronic disease patients can help effectively prevent the recurrence of poverty or new poverty caused by illness at its root.

To understand the Ningxia of health poverty vulnerability among rural residents with chronic diseases and its influencing factors, and to provide theoretical support and practical suggestions for formulating more precise and effective poverty alleviation policies and measures.

From June to July 2022, a multistage stratified cluster random sampling method was used to select participants from four counties (Yanchi, Haiyuan, Xiji, and Pengyang) in Ningxia Hui Autonomous Region. The questionnaire, designed based on literature research and expert consultation, covered demographic characteristics, health status and behaviors, medical security, and family economic conditions. The health poverty vulnerability index for chronic disease patients was calculated using the three-stage feasible generalized least squares (FGLS) method. Binary Logistic regression was employed to explore influencing factors, and Shapley value decomposition was used to quantify the contribution of each factor.

A total of 4 778 chronic disease patients were included. Using a threshold of health poverty vulnerability index > 0.5, 253 were classified into the health poverty vulnerable group and 4 525 into the non-vulnerable group. Logit regression showed that age and seeking care at township health centers or county hospitals were risk factors for health poverty vulnerability (P<0.05). Protective factors included primary or junior high school education, self-rated general or good health, longer disease duration, ≥6 conscious exercise sessions per week, participation in urban-rural integrated basic medical insurance or employee medical insurance, and risk-based health expenditures (P<0.05). Shapley value decomposition indicated that individual characteristics contributed the most (43.51%), followed by health status (21.26%) and disease burden (18.81%).

The health poverty vulnerability of chronic disease patients in Ningxia remains relatively high nationwide. Key factors include age, catastrophic health expenditure, self-rated health, weekly exercise frequency, education level, and disease duration. Governments should increase investments, strengthen health education and promotion campaigns, improve medical service systems and healthcare security mechanisms for chronic disease patients, and foster cross-sector collaboration to establish an early warning platform for health poverty vulnerability.

在后扶贫时代，深入研究慢性病患者的健康贫困脆弱性，有助于从源头上有效防止因病返贫、因病致贫现象的发生。

了解宁夏回族自治区农村居民慢性病患者健康贫困脆弱性及影响因素，为制订更加精准、有效的健康支持政策与策略提供理论支持和建议。

于2022年6—7月，采用多阶段分层整群随机抽样的方法于宁夏回族自治区盐池县、海原县、西吉县、彭阳县4个县选取调查对象，调查问卷由课题组在文献研究、专家咨询的基础上设计完成，内容包括居民人口学特征、健康水平与健康行为、医疗保障情况、家庭及经济情况。运用三阶段可行广义最小二乘法（FGLS）计算慢性病患者健康贫困脆弱性指数，利用二元Logistic回归探讨慢性病患者健康贫困脆弱性的影响因素，并采用Shapley值分解量化各影响因素的贡献程度。

最终共纳入4 778名慢性病患者，根据健康贫困脆弱性指数计算结果，将健康贫困脆弱指数>0.5定义为健康贫困脆弱，研究对象分为健康贫困脆弱组253名，非健康贫困脆弱性组4 525名。Logistic回归分析结果显示，年龄、最近看病点为乡卫生院和县医院是慢性病患者出现健康贫困脆弱性的危险因素（P<0.05）；文化程度为小学和初中、自评健康状况为一般与健康、患病年限越长、每周有意识的锻炼次数为6次及以上、参加城乡统筹基本医疗或城镇职工医疗保险、风险性卫生支出是健康贫困脆弱性的保护因素（P<0.05）。Shapley值分解结果表明个人特征贡献最大（43.51%）、其次是健康水平（21.26%）与疾病负担（18.81%）。

宁夏慢性病患者健康贫困脆弱性在全国范围内处于较高水平，年龄、风险性卫生支出、自评健康状况、每周有意识锻炼次数、文化程度、最长患病年限等是影响宁夏慢性病患者健康贫困脆弱性的关键因素。政府需不断加大投入力度，持续加强健康教育，开展健康促进行动；完善慢性病患者医疗服务体系，加强医疗保障制度建设；各级医疗卫生机构通力协作，构建健康贫困脆弱性预警平台。