《保险研究》20210703-《中国老龄人口健康受损进展与持续时间研究》（董明英、王晓军）

［摘   要］探究老龄人口健康受损进展的规律对实施健康老龄化政策具有实际意义。本文构建了老年人健康受损进展模型和健康状态转移模型,基于2014~2018年中国老年健康影响因素跟踪调查(CLHLS)数据,对老年人健康受损进展规律和持续时间进行研究,对不同类型人群的健康受损进展差异进行比较。研究发现:老年人群的健康状态呈现出从健康到患病,从患病到功能受限,从功能受限到失能逐步递进的规律性；相比而言,女性具有生存优势,男性具有健康优势；城镇老年人的失能持续时间更长,其在基本日常生活不能自理状态的停留时间约为乡村老年人的1.21倍；与配偶同住的老年人在健康受损过程中享有更多的健康,其在健康状态的持续时间平均为未与配偶同住老年人的1.23倍,在基本日常生活不能自理状态的持续时间仅为未与配偶同住老年人的88.6%。随着年龄增长,老年人的健康恢复情况变差,85岁以上老年人健康恢复能力几近丧失。

［关键词］健康受损；功能受限；日常生活不能自理；健康转移

［基金项目］教育部哲学社会科学研究重大课题攻关项目“健康中国2030背景下的健康老龄化体系优化研究”(20JZD023)。

［作者简介］董明英,中国人民大学统计学院博士研究生,研究方向:风险管理与精算学;王晓军(通讯作者),中国人民大学应用统计科学研究中心研究员,统计学院教授,博士生导师,研究方向:风险管理与保险精算。

The Progress and Duration of Health Impairment among Elderly People in China

DONG Ming-ying,WANG Xiao-jun

Abstract：The study on the progress and duration of health impairment among the elderly in China is important for healthy aging.In this paper,we constructed the progress model of elderly health impairment and the health state transition model.Based on the data of Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2014 to 2018,we studied the progress of elderly health impairment,and compared the differences of health impairment progress among different types of people.The results show that the health state of the elderly is gradually progressive from health to illness,from illness to functional limitation,and from functional limitation to disability.In comparison,females have survival advantage and males have health advantage;the duration of disability for the urban elderly is longer those in rural areas,and the time that the urban elderly cannot perform basic daily life activities is about 1.21 times that of the rural elderly.Elderly people who live with spouses are healthier,they are,on average,1.23 times longer in health than those who don′t live with spouses,and their duration of being unable to perform basic daily life activities is only 88.6% of the latter.With the increase of age,the state of health of the elderly becomes worse,and the elderly over 85 years of age loses almost all health recovery ability.

Key words：health impairment;functional limitations;inability to perform activities of daily living;health transfer