老年慢性病共存患者治疗负担及其影响因素研究 [中文引用][英文引用]

目的  探讨老年慢性病共存患者的治疗负担现状及其影响因素，为优化该类人群慢性病综合管理提供依据。方法  选取 2024 年 6 月— 2025 年 6 月在本院门诊就诊的 400 例 60 岁及以上且患有 2 种及以上慢性病的老年患者为研究对象。采用一般资料调查表和慢性病共存治疗负担问卷（multimorbidity treatment burden questionnaire，MTBQ）对其进行调查。采用有序 Logistic回归模型分析其治疗负担的影响因素。结果  392例患者完成研究，治疗负担程度：5例（1.28%）无负担，52例（13.27%）低度负担，195 例（49.74%）中度负担，140 例（35.71%）高度负担；文化程度、家庭人均月收入、医疗费用类型、慢性病数量以及Charlson 合并症指数（Charlson comorbidity index，CCI）总分、应对方式、健康素养、社会支持是老年共病患者治疗负担的影响因素（均 P<0.05）。结论  老年慢性病共存患者总体治疗负担较重，以中、高度治疗负担为主。临床医护人员重点关注文化程度、家庭人均月收入、医疗费用类型、慢性病数量、CCI 总分、应对方式、健康素养及社会支持等具有较高治疗负担风险特征的患者，采取针对性的管理措施以减轻其治疗负担。

Objective To investigate current status of the treatment burden among aged adults with multiple chronic conditions and the associated factors，thereby providing a basis for optimising the comprehensive management of chronic diseases. Methods The study included 400 patients aged 60 years and above with two or more chronic conditions and received outpatient care at our hospital between June 2024 and June 2025. The patients were assessed using a demographic questionnaire and the multimorbidity treatment burden questionnaire（MTBQ）. An ordered logistic regression model was used to analyse the factors influencing the treatment burden. Results A total of 392 completed the study. The distribution of treatment burden among the 392 patients was found as follows：5 patients （1.28%）reported without a burden，52 patients（13.27%）with a low burden，195 patients（49.74%）with a moderate burden，and 140 patients（35.71%）with a high burden. Education，average monthly household income，type of medical expenses，number of chronic diseases，total score of Charlson comorbidity index（CCI），coping strategies，health literacy，and social support were found as the factors influencing treatment burden of the patients（all P<0.05）. Conclusion Aged adults with coexisting chronic conditions face a relatively heavy overall burden in medical treatment，most of them with moderate to high treatment burdens. Educational attainment，per capita monthly household income，type of medical expenses，number of chronic conditions，total CCI score，coping strategies，health literacy，and social support are all associated with the treatment burden. Healthcare providers should strengthen the assessment of treatment burden，focus on the patients with risk factors of a higher treatment burden，and implement targeted measures in conjunction with the associated factors to alleviate the treatment burden.