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Article(id=1322609118813213566, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322609030938346427, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506289, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750176000000, receivedDateStr=2025-06-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793264186814, onlineDateStr=2026-10-29, pubDate=1764000000000, pubDateStr=2025-11-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793264186814, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793264186814, creator=13701087609, updateTime=1793264186814, updator=13701087609, issue=Issue{id=1322609030938346427, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='22', pageStart='4033', pageEnd='4224', issueExtLink='null', onlineDate='null', pubDate='1764000000000', pubDateStr='2025-11-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793264165863, creator='13701087609', updateTime=1793264299902, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322609593264489401, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322609030938346427, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322609593264489402, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322609030938346427, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=4105, endPage=4111, ext={EN=ArticleExt(id=1322609119052288895, articleId=1322609118813213566, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=The determinants of long-term care needs among the middle-aged and elderly population: a study based on the 2020 China Health and Retirement Longitudinal Study（CHARLS）data, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the current status and influencing factors of long-term care needs among middle-aged and older adults in China, and to provide a reference for optimizing long-term care services and formulating precise policy supply.

Methods

Using data from the 2020 China Health and Retirement Longitudinal Study（CHARLS）, this study focused on individuals aged 45 and above. Andersen’s Behavioral Model of Health Services Use was employed as the theoretical framework. Fisher’s exact test and multinomial logistic regression models were utilized for the analysis.

Results

75.97% preferred home-based long-term care, 1.82% preferred long-term care in nursing homes, 1.05% chose hospital-based long-term care, and 21.16% selected other care options. In terms of predisposing characteristics, males were more likely to prefer nursing home care（OR=2.19, 95% CI=1.16-4.12）and other care options（OR=1.75, 95% CI=1.37-2.22）. Individuals aged 75 and above were more inclined toward hospital-based long-term care（OR=3.80, 95% CI=1.51-9.55）. Divorced（OR=23.62, 95% CI=3.69-151.30）, widowed（OR=43.70, 95% CI=12.88-148.27）, and other marital status groups（OR=26.45, 95% CI=7.50-93.35）were more likely to choose nursing home care. Regarding enabling resources, those with pensions or wages were less likely to choose nursing home care（OR=0.17, 95% CI=0.06-0.51）but more likely to select other care options（OR=3.74, 95% CI=2.93-4.77）. In terms of psychosocial factors, individuals who participated in social activities were less likely to prefer hospital care（OR=0.40, 95% CI=0.18-0.89）and other long-term care options（OR=0.54, 95% CI=0.43-0.67）. Those with depressive tendencies were more likely to prefer nursing home care（OR=0.40, 95% CI=0.14-0.91）.

Conclusion

The long-term care needs of middle-aged and older adults in China are influenced by factors such as gender, age, marital status, pensions or wages, participation in social activities, and depressive tendencies. There are still significant limitations in their autonomous choice of care options, with family-based care being the predominant preference. Therefore, the government should strengthen the top-level design of long-term care service systems, improve policy support, optimize the coordinated governance of multiple departments such as civil affairs, health, and medical insurance, increase support for home-based elderly care, and provide multi-level long-term care services.

, authors=Yue ZHOU, Gui-min DUAN, Xiang ZHOU, Jia-ni TANG, Yuan DUAN, authorsList=Yue ZHOU, Gui-min DUAN, Xiang ZHOU, Jia-ni TANG, Yuan DUAN, authorCompany=null, correspAuthors=Gui-min DUAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322609121266881410, articleId=1322609118813213566, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=基于2020年CHARLS数据的中老年人长期照护需求影响因素研究, columnId=1228016573533847611, journalTitle=现代预防医学, columnName=基层卫生服务, runingTitle=null, highlight=null, articleAbstract=
目的

分析我国中老年人长期照护需求现状及其影响因素，为优化中老年人长期照护服务、精准供给政策提供参考依据。

方法

使用2020年CHARLS数据，以45岁及以上的中老年人为研究对象，以Andersen模型为理论框架，运用Fisher精确检验与无序多分类logistic回归模型开展分析。

结果

75.97%的中老年人倾向于居家长期照护方式，1.82%的中老年人倾向于养老院长期照护方式，1.05%的中老年人选择医院长期照护方式，21.16%的中老年人选择其他照护方式。其中，在倾向特征层面上，男性更倾向于养老院长期照护方式（OR=2.19，95% CI=1.16~4.12）和其他长期照护方式（OR=1.75，95% CI=1.37~2.22）；75岁及以上的老年人群更倾向于医院长期照护方式（OR=3.80，95% CI=1.51~9.55）；离异（OR=23.62，95% CI=3.69~151.30）、丧偶（OR=43.70，95% CI=12.88~148.27）与其它婚姻状况（OR=26.45，95% CI=7.50~93.35）的中老年群体更倾向于选择养老院长期照护方式。在使能资源层面上，有退休金或工资的中老年群体更倾向于选择养老院（OR=0.17，95% CI=0.06~0.51）和其他照护方式（OR=3.74，95% CI=2.93~4.77）。在心理社会因素层面上，有社交活动参与的中老年群体更倾向于医院（OR=0.40，95% CI=0.18~0.89）和其他长期照护方式（OR=0.54,95% CI=0.43~0.67）；有抑郁倾向的中老年群体更倾向于养老院长期照护方式（OR=0.40，95% CI=0.14~0.91）。

结论

我国中老年群体长期照护需求受性别、年龄、婚姻状况、退休金或工资、有无社交活动参与、有无抑郁倾向等因素影响，在自主选择照护方式上仍有较大局限，长期照护需求以家庭照护为主。因此政府应加强长期照护服务制度的顶层设计，完善政策配套设施，优化民政、卫健以及医保等多部门协同治理，加大居家养老支持力度，提供多层次长期照护服务。

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周悦（2000—），女，硕士在读，研究方向：卫生事业管理

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段桂敏，E-mail：
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Academic Forum, 2024, 47 (1): 16-28.（In Chinese）, articleTitle=Improving service quality of elderly care facilities and integrated People-Centered elderly care: based on field investigations in three elderly care facilities, refAbstract=null), Reference(id=1322609131022832593, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, doi=null, pmid=null, pmcid=null, year=2014, volume=null, issue=3, pageStart=15, pageEnd=22, url=null, language=null, rfNumber=[17], rfOrder=32, authorNames=陶涛, 丛聪, journalName=人口与经济, refType=null, unstructuredReference=陶涛，丛聪. 老年人养老方式选择的影响因素分析--以北京市西城区为例 [J]. 人口与经济, 2014 (3): 15-22., articleTitle=老年人养老方式选择的影响因素分析--以北京市西城区为例, refAbstract=null), Reference(id=1322609131102524370, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, doi=null, pmid=null, pmcid=null, year=2014, volume=null, issue=3, pageStart=15, pageEnd=22, url=null, language=null, rfNumber=[17], rfOrder=33, authorNames=Tao T, Cong C, journalName=Population & Economics, refType=null, unstructuredReference=Tao T, Cong C. An analysis of influencing factors on elder’ s preference for patterns of old-age support: Some empirical evidence from Beijing Xicheng district [J]. Population & Economics, 2014 (3): 15-22.（In Chinese）, articleTitle=An analysis of influencing factors on elder’ s preference for patterns of old-age support: Some empirical evidence from Beijing Xicheng district, refAbstract=null), Reference(id=1322609131198993363, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, doi=null, pmid=null, pmcid=null, year=2008, volume=67, issue=6, pageStart=1002, pageEnd=1008, url=null, language=null, rfNumber=[18], rfOrder=34, authorNames=Hanaoka C, Norton EC, journalName=Social Science & Medicine, refType=null, unstructuredReference=Hanaoka C, Norton EC. Informal and formal care for elderly persons: How adult children’s characteristics affect the use of formal care in Japan [J]. Social Science & Medicine, 2008, 67 (6): 1002-1008., articleTitle=Informal and formal care for elderly persons: How adult children’s characteristics affect the use of formal care in Japan, refAbstract=null), Reference(id=1322609131274490836, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, doi=null, pmid=null, pmcid=null, year=2022, volume=28, issue=6, pageStart=25, pageEnd=33, url=null, language=null, rfNumber=[19], rfOrder=35, authorNames=林威霞, 宋新明, journalName=人口与发展, refType=null, unstructuredReference=林威霞，宋新明. 中国老年人群功能受限对移动障碍发生的影响研究 [J]. 人口与发展, 2022, 28 (6): 25-33., articleTitle=中国老年人群功能受限对移动障碍发生的影响研究, refAbstract=null), Reference(id=1322609131341599701, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, doi=null, pmid=null, pmcid=null, year=2022, volume=28, issue=6, pageStart=25, pageEnd=33, url=null, language=null, rfNumber=[19], rfOrder=36, authorNames=Lin WX, Song XM, journalName=Population and Development, refType=null, unstructuredReference=Lin WX, Song XM. The effects of functional limitations on mobility disability in Chinese older adults [J]. Population and Development, 2022, 28 (6): 25-33.（In Chinese）, articleTitle=The effects of functional limitations on mobility disability in Chinese older adults, refAbstract=null), Reference(id=1322609131425485782, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, doi=null, pmid=null, pmcid=null, year=2023, volume=null, issue=2, pageStart=136, pageEnd=149, url=null, language=null, rfNumber=[20], rfOrder=37, authorNames=姜春, 刘辉, journalName=宁夏社会科学, refType=null, unstructuredReference=姜春，刘辉. 积极老龄化背景下机构养老服务质量研究的理论框架及其新维度 [J]. 宁夏社会科学, 2023, (2): 136-149., articleTitle=积极老龄化背景下机构养老服务质量研究的理论框架及其新维度, refAbstract=null), Reference(id=1322609131496788951, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, doi=null, pmid=null, pmcid=null, year=2023, volume=null, issue=2, pageStart=136, pageEnd=149, url=null, language=null, rfNumber=[20], rfOrder=38, authorNames=Jiang C, Liu H, journalName=Social Sciences in Ningxia, refType=null, unstructuredReference=Jiang C, Liu H. Quality of service in nursing home: a literature review and future research agenda [J]. Social Sciences in Ningxia, 2023, (2): 136-149.（In Chinese）, articleTitle=Quality of service in nursing home: a literature review and future research agenda, refAbstract=null)], funds=[Fund(id=1322609125767369643, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, awardId=21YJAZH016, language=CN, fundingSource=教育部人文社科规划基金项目(21YJAZH016), fundOrder=null, country=null), Fund(id=1322609125830284204, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, awardId=SWFZ24-Z-10, language=CN, fundingSource=四川省基层卫生事业发展研究中心重点项目(SWFZ24-Z-10), fundOrder=null, country=null), Fund(id=1322609125905781677, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, awardId=ZYYWH2024010, language=CN, fundingSource=四川省中医药文化与中医药发展研究中心重点项目(ZYYWH2024010), fundOrder=null, country=null), Fund(id=1322609125968696238, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, awardId=2023MS507, language=CN, fundingSource=四川省中医药管理局管理及决策项目(2023MS507), fundOrder=null, country=null), Fund(id=1322609126035805103, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, awardId=DJKWT202301, language=CN, fundingSource=四川中医药大健康产业发展与乡村振兴研究中心重点项目(DJKWT202301), fundOrder=null, country=null), Fund(id=1322609126107108272, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, awardId=QJRC2022056, language=CN, fundingSource=成都中医药大学杏林学者青基人才项目(QJRC2022056), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322609121615008643, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, xref=null, ext=[AuthorCompanyExt(id=1322609121623397252, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, companyId=1322609121615008643, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Business School of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China), AuthorCompanyExt(id=1322609121627591557, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, companyId=1322609121615008643, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=成都中医药大学管理学院，四川　成都　611137)])], figs=[ArticleFig(id=1322609123875738535, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, language=EN, label=Table 1, caption=

Fisher’s exact test for long-term care needs among middle-aged and older adults[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量合计
（n=2 576）		家庭
（n=1 957）		养老院
（n=47）		医院
（n=31）		其他
（n=541）		 P
倾向特征
性别87.63<0.001
男1 389（53.9）961（49.1）25（53.2）15（48.4）388（71.7）
女1 187（46.1）996（50.9）22（46.8）16（51.6）153（28.3）
年龄（岁）13.840.030
45~591 602（62.2）1 210（61.8）35（74.5）18（58.1）339（62.7）
60~74801（31.1）622（31.8）11（23.4）6（19.4）162（29.9）
≥75173（6.7）125（6.4）1（2.1）7（22.6）40（7.4）
受教育水平10.960.278
小学及以下1 105（42.9）849（43.4）16（34.0）13（41.9）227（42.0）
初中998（38.8）734（37.5）22（46.8）15（48.4）227（42.0）
高中320（12.4）248（12.7）8（17.0）2（7.4）62（11.5）
中专及以上153（5.9）126（6.4）1（2.1）1（3.7）25（4.6）
婚姻状况509.70<0.001
已婚1 524（59.2）1 345（68.7）3（6.4）9（29.0）167（30.9）
离异56（2.2）42（2.1）2（4.3）2（6.5）10（1.8）
丧偶305（11.8）246（12.6）27（57.4）4（12.9）28（5.2）
其他691（26.8）324（16.6）15（31.9）16（51.6）336（62.1）
居住地类型4.350.642
城镇1 108（43.0）835（42.7）19（40.4）12（38.7）242（44.7）
城乡结合区490（19.0）388（19.8）9（19.1）5（16.1）88（16.3）
农村及其他地区978（38.0）734（37.5）19（40.4）14（45.2）211（39.0）
使能资源
退休金或工资331.65<0.001
有1 113（43.2）685（35.0）4（8.5）10（32.3）414（76.5）
无1 463（56.8）1 272（65.0）43（91.5）21（67.7）127（23.5）
子女数量10.730.291
1658（25.5）507（25.9）12（25.5）5（16.1）134（24.8）
21 151（44.7）877（44.8）23（48.9）9（29.0）242（44.7）
3442（17.2）332（17.0）8（17.0）11（35.5）91（16.8）
≥4325（12.6）241（12.3）4（8.5）6（19.4）74（13.7）
子女联系频率29.120.273
每天一次279（10.8）219（11.2）4（8.5）4（12.9）52（9.6）
每周2~3次165（6.4）129（6.6）3（6.4）2（6.5）31（5.7）
每周一次272（10.6）212（10.8）6（12.8）3（9.7）51（9.4）
每半个月一次256（9.9）202（10.3）5（10.6）4（12.9）45（8.3）
每月一次649（25.1）502（25.7）11（23.4）9（29.0）126（23.3）
每三个月一次282（10.9）214（10.9）4（8.5）5（16.1）59（10.9）
半年一次292（11.3）204（10.4）8（17.0）3（9.7）77（14.2）
每年一次245（9.5）179（9.1）1（2.1）1（3.2）64（11.8）
几乎从不76（2.9）51（2.6）2（4.3）0（0.0）23（4.3）
其他61（2.4）45（2.3）3（6.4）0（0.0）13（2.4）
需求因素
慢性病14.160.002
有1 019（39.6）788（40.3）29（61.7）10（32.3）192（35.5）
无1 557（60.4）1 169（59.7）18（38.3）21（67.7）349（64.5）
自评健康状况20.320.002
好616（23.9）471（24.1）3（6.4）4（12.9）138（25.5）
一般1 572（61.0）1 171（59.8）36（76.6）24（77.4）341（63.0）
不好388（15.1）315（16.1）8（17.0）3（9.7）62（11.5）
心理社会因素
生活满意度2.260.512
满意2 351（91.3）1 793（91.6）44（93.6）29（93.5）485（89.6）
不满意225（8.7）164（8.4）3（6.4）2（6.5）56（10.4）
代际关系满意度5.020.137
满意2 473（96.0）1 882（96.4）45（95.7）28（90.3）514（95.0）
不满意103（4.0）71（3.6）2（4.3）3（9.7）27（5.0）
有无抑郁倾向8.250.043
有627（24.3）476（24.3）6（12.8）3（9.7）142（26.2）
无1 949（75.7）1 481（75.7）41（87.2）28（90.3）399（73.8）
社交活动参与53.58<0.001
有1 230（47.7）1 013（51.8）16（34.0）9（29.0）192（35.5）
无1 346（52.3）944（48.2）31（66.0）22（71.0）349（64.5）
), ArticleFig(id=1322609125498934184, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, language=CN, label=表1, caption=

中老年人长期照护需求的Fisher精确检验[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量合计
（n=2 576）		家庭
（n=1 957）		养老院
（n=47）		医院
（n=31）		其他
（n=541）		 P
倾向特征
性别87.63<0.001
男1 389（53.9）961（49.1）25（53.2）15（48.4）388（71.7）
女1 187（46.1）996（50.9）22（46.8）16（51.6）153（28.3）
年龄（岁）13.840.030
45~591 602（62.2）1 210（61.8）35（74.5）18（58.1）339（62.7）
60~74801（31.1）622（31.8）11（23.4）6（19.4）162（29.9）
≥75173（6.7）125（6.4）1（2.1）7（22.6）40（7.4）
受教育水平10.960.278
小学及以下1 105（42.9）849（43.4）16（34.0）13（41.9）227（42.0）
初中998（38.8）734（37.5）22（46.8）15（48.4）227（42.0）
高中320（12.4）248（12.7）8（17.0）2（7.4）62（11.5）
中专及以上153（5.9）126（6.4）1（2.1）1（3.7）25（4.6）
婚姻状况509.70<0.001
已婚1 524（59.2）1 345（68.7）3（6.4）9（29.0）167（30.9）
离异56（2.2）42（2.1）2（4.3）2（6.5）10（1.8）
丧偶305（11.8）246（12.6）27（57.4）4（12.9）28（5.2）
其他691（26.8）324（16.6）15（31.9）16（51.6）336（62.1）
居住地类型4.350.642
城镇1 108（43.0）835（42.7）19（40.4）12（38.7）242（44.7）
城乡结合区490（19.0）388（19.8）9（19.1）5（16.1）88（16.3）
农村及其他地区978（38.0）734（37.5）19（40.4）14（45.2）211（39.0）
使能资源
退休金或工资331.65<0.001
有1 113（43.2）685（35.0）4（8.5）10（32.3）414（76.5）
无1 463（56.8）1 272（65.0）43（91.5）21（67.7）127（23.5）
子女数量10.730.291
1658（25.5）507（25.9）12（25.5）5（16.1）134（24.8）
21 151（44.7）877（44.8）23（48.9）9（29.0）242（44.7）
3442（17.2）332（17.0）8（17.0）11（35.5）91（16.8）
≥4325（12.6）241（12.3）4（8.5）6（19.4）74（13.7）
子女联系频率29.120.273
每天一次279（10.8）219（11.2）4（8.5）4（12.9）52（9.6）
每周2~3次165（6.4）129（6.6）3（6.4）2（6.5）31（5.7）
每周一次272（10.6）212（10.8）6（12.8）3（9.7）51（9.4）
每半个月一次256（9.9）202（10.3）5（10.6）4（12.9）45（8.3）
每月一次649（25.1）502（25.7）11（23.4）9（29.0）126（23.3）
每三个月一次282（10.9）214（10.9）4（8.5）5（16.1）59（10.9）
半年一次292（11.3）204（10.4）8（17.0）3（9.7）77（14.2）
每年一次245（9.5）179（9.1）1（2.1）1（3.2）64（11.8）
几乎从不76（2.9）51（2.6）2（4.3）0（0.0）23（4.3）
其他61（2.4）45（2.3）3（6.4）0（0.0）13（2.4）
需求因素
慢性病14.160.002
有1 019（39.6）788（40.3）29（61.7）10（32.3）192（35.5）
无1 557（60.4）1 169（59.7）18（38.3）21（67.7）349（64.5）
自评健康状况20.320.002
好616（23.9）471（24.1）3（6.4）4（12.9）138（25.5）
一般1 572（61.0）1 171（59.8）36（76.6）24（77.4）341（63.0）
不好388（15.1）315（16.1）8（17.0）3（9.7）62（11.5）
心理社会因素
生活满意度2.260.512
满意2 351（91.3）1 793（91.6）44（93.6）29（93.5）485（89.6）
不满意225（8.7）164（8.4）3（6.4）2（6.5）56（10.4）
代际关系满意度5.020.137
满意2 473（96.0）1 882（96.4）45（95.7）28（90.3）514（95.0）
不满意103（4.0）71（3.6）2（4.3）3（9.7）27（5.0）
有无抑郁倾向8.250.043
有627（24.3）476（24.3）6（12.8）3（9.7）142（26.2）
无1 949（75.7）1 481（75.7）41（87.2）28（90.3）399（73.8）
社交活动参与53.58<0.001
有1 230（47.7）1 013（51.8）16（34.0）9（29.0）192（35.5）
无1 346（52.3）944（48.2）31（66.0）22（71.0）349（64.5）
), ArticleFig(id=1322609125603791785, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609118813213566, language=EN, label=Table 2, caption=

Multivariate logistic regression analysis results for long-term care needs among middle-aged and older adults

, figureFileSmall=null, figureFileBig=null, tableContent=
变量养老院医院其他
OR（95% CI）POR（95% CI）POR（95% CI）P
倾向特征
性别
女性
男性2.19（1.16~4.12）0.0160.94（0.44~2.02）0.8731.75（1.37~2.22）<0.001
年龄（岁）
45~59
60~740.62（0.30~1.28）0.1950.65（0.26~1.67）0.3740.98（0.77~1.26）0.895
≥750.30（0.04~2.30）0.2463.80（1.51~9.55）0.0041.04（0.67~1.61）0.854
婚姻状况
已婚
离异23.62（3.69~151.30）0.0018.82（1.80~43.23）0.0071.65（0.79~3.48）0.185
丧偶43.70（12.88~148.27）<0.0012.12（0.63~7.15）0.2251.24（0.79~1.93）0.353
其他26.45（7.50~93.35）<0.0017.38（3.15~17.27）<0.0015.90（4.66~7.47）<0.001
使能资源
退休金或工资
无
有0.17（0.06~0.51）0.0010.65（0.28~1.48）0.3033.74（2.93~4.77）<0.001
需求因素
慢性病
无
有1.72（0.91~3.27）0.0960.75（0.34~1.63）0.4610.93（0.73~1.17）0.528
自评健康状况
不好
一般1.14（0.48~2.75）0.7641.55（0.44~5.50）0.4991.23（0.86~1.76）0.255
好0.40（0.10~1.71）0.2170.78（0.16~3.82）0.7541.22（0.81~1.84）0.340
心理社会因素
社交活动参与
无
有0.70（0.37~1.33）0.2700.40（0.18~0.89）0.0240.54（0.43~0.67）<0.001
有无抑郁倾向
无
有0.36（0.14~0.91）0.0310.32（0.09~1.10）0.0701.19（0.91~1.56）0.200
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中老年人长期照护需求的多元logistic回归分析结果

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变量养老院医院其他
OR（95% CI）POR（95% CI）POR（95% CI）P
倾向特征
性别
女性
男性2.19（1.16~4.12）0.0160.94（0.44~2.02）0.8731.75（1.37~2.22）<0.001
年龄（岁）
45~59
60~740.62（0.30~1.28）0.1950.65（0.26~1.67）0.3740.98（0.77~1.26）0.895
≥750.30（0.04~2.30）0.2463.80（1.51~9.55）0.0041.04（0.67~1.61）0.854
婚姻状况
已婚
离异23.62（3.69~151.30）0.0018.82（1.80~43.23）0.0071.65（0.79~3.48）0.185
丧偶43.70（12.88~148.27）<0.0012.12（0.63~7.15）0.2251.24（0.79~1.93）0.353
其他26.45（7.50~93.35）<0.0017.38（3.15~17.27）<0.0015.90（4.66~7.47）<0.001
使能资源
退休金或工资
无
有0.17（0.06~0.51）0.0010.65（0.28~1.48）0.3033.74（2.93~4.77）<0.001
需求因素
慢性病
无
有1.72（0.91~3.27）0.0960.75（0.34~1.63）0.4610.93（0.73~1.17）0.528
自评健康状况
不好
一般1.14（0.48~2.75）0.7641.55（0.44~5.50）0.4991.23（0.86~1.76）0.255
好0.40（0.10~1.71）0.2170.78（0.16~3.82）0.7541.22（0.81~1.84）0.340
心理社会因素
社交活动参与
无
有0.70（0.37~1.33）0.2700.40（0.18~0.89）0.0240.54（0.43~0.67）<0.001
有无抑郁倾向
无
有0.36（0.14~0.91）0.0310.32（0.09~1.10）0.0701.19（0.91~1.56）0.200
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基于2020年CHARLS数据的中老年人长期照护需求影响因素研究
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周悦 , 段桂敏 , 周翔 , 唐佳妮 , 段媛
现代预防医学 | 基层卫生服务 2025,52(22): 4105-4111
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现代预防医学 |基层卫生服务 2025 , 52 (22) : 4105 -4111
基于2020年CHARLS数据的中老年人长期照护需求影响因素研究
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周悦, 段桂敏 , 周翔, 唐佳妮, 段媛
作者信息
  • 成都中医药大学管理学院，四川　成都　611137
通讯作者:
段桂敏，E-mail：
作者简介:

周悦（2000—），女，硕士在读，研究方向：卫生事业管理

The determinants of long-term care needs among the middle-aged and elderly population: a study based on the 2020 China Health and Retirement Longitudinal Study（CHARLS）data
Yue ZHOU, Gui-min DUAN , Xiang ZHOU, Jia-ni TANG, Yuan DUAN
Affiliations
  • Business School of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China
出版时间: 2025-11-25 doi: 10.20043/j.cnki.MPM.202506289
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摘要
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目的

分析我国中老年人长期照护需求现状及其影响因素，为优化中老年人长期照护服务、精准供给政策提供参考依据。

方法

使用2020年CHARLS数据，以45岁及以上的中老年人为研究对象，以Andersen模型为理论框架，运用Fisher精确检验与无序多分类logistic回归模型开展分析。

结果

75.97%的中老年人倾向于居家长期照护方式，1.82%的中老年人倾向于养老院长期照护方式，1.05%的中老年人选择医院长期照护方式，21.16%的中老年人选择其他照护方式。其中，在倾向特征层面上，男性更倾向于养老院长期照护方式（OR=2.19，95% CI=1.16~4.12）和其他长期照护方式（OR=1.75，95% CI=1.37~2.22）；75岁及以上的老年人群更倾向于医院长期照护方式（OR=3.80，95% CI=1.51~9.55）；离异（OR=23.62，95% CI=3.69~151.30）、丧偶（OR=43.70，95% CI=12.88~148.27）与其它婚姻状况（OR=26.45，95% CI=7.50~93.35）的中老年群体更倾向于选择养老院长期照护方式。在使能资源层面上，有退休金或工资的中老年群体更倾向于选择养老院（OR=0.17，95% CI=0.06~0.51）和其他照护方式（OR=3.74，95% CI=2.93~4.77）。在心理社会因素层面上，有社交活动参与的中老年群体更倾向于医院（OR=0.40，95% CI=0.18~0.89）和其他长期照护方式（OR=0.54,95% CI=0.43~0.67）；有抑郁倾向的中老年群体更倾向于养老院长期照护方式（OR=0.40，95% CI=0.14~0.91）。

结论

我国中老年群体长期照护需求受性别、年龄、婚姻状况、退休金或工资、有无社交活动参与、有无抑郁倾向等因素影响，在自主选择照护方式上仍有较大局限，长期照护需求以家庭照护为主。因此政府应加强长期照护服务制度的顶层设计，完善政策配套设施，优化民政、卫健以及医保等多部门协同治理，加大居家养老支持力度，提供多层次长期照护服务。

中老年人  /  长期照护需求  /  安德森模型  /  影响因素
Objective

To analyze the current status and influencing factors of long-term care needs among middle-aged and older adults in China, and to provide a reference for optimizing long-term care services and formulating precise policy supply.

Methods

Using data from the 2020 China Health and Retirement Longitudinal Study（CHARLS）, this study focused on individuals aged 45 and above. Andersen’s Behavioral Model of Health Services Use was employed as the theoretical framework. Fisher’s exact test and multinomial logistic regression models were utilized for the analysis.

Results

75.97% preferred home-based long-term care, 1.82% preferred long-term care in nursing homes, 1.05% chose hospital-based long-term care, and 21.16% selected other care options. In terms of predisposing characteristics, males were more likely to prefer nursing home care（OR=2.19, 95% CI=1.16-4.12）and other care options（OR=1.75, 95% CI=1.37-2.22）. Individuals aged 75 and above were more inclined toward hospital-based long-term care（OR=3.80, 95% CI=1.51-9.55）. Divorced（OR=23.62, 95% CI=3.69-151.30）, widowed（OR=43.70, 95% CI=12.88-148.27）, and other marital status groups（OR=26.45, 95% CI=7.50-93.35）were more likely to choose nursing home care. Regarding enabling resources, those with pensions or wages were less likely to choose nursing home care（OR=0.17, 95% CI=0.06-0.51）but more likely to select other care options（OR=3.74, 95% CI=2.93-4.77）. In terms of psychosocial factors, individuals who participated in social activities were less likely to prefer hospital care（OR=0.40, 95% CI=0.18-0.89）and other long-term care options（OR=0.54, 95% CI=0.43-0.67）. Those with depressive tendencies were more likely to prefer nursing home care（OR=0.40, 95% CI=0.14-0.91）.

Conclusion

The long-term care needs of middle-aged and older adults in China are influenced by factors such as gender, age, marital status, pensions or wages, participation in social activities, and depressive tendencies. There are still significant limitations in their autonomous choice of care options, with family-based care being the predominant preference. Therefore, the government should strengthen the top-level design of long-term care service systems, improve policy support, optimize the coordinated governance of multiple departments such as civil affairs, health, and medical insurance, increase support for home-based elderly care, and provide multi-level long-term care services.

Middle-aged and elderly population  /  Long-term care needs  /  Andersen model  /  Determinants
周悦, 段桂敏, 周翔, 唐佳妮, 段媛. 基于2020年CHARLS数据的中老年人长期照护需求影响因素研究. 现代预防医学, 2025 , 52 (22) : 4105 -4111 . DOI: 10.20043/j.cnki.MPM.202506289
Yue ZHOU, Gui-min DUAN, Xiang ZHOU, Jia-ni TANG, Yuan DUAN. The determinants of long-term care needs among the middle-aged and elderly population: a study based on the 2020 China Health and Retirement Longitudinal Study（CHARLS）data[J]. Modern Preventive Medicine, 2025 , 52 (22) : 4105 -4111 . DOI: 10.20043/j.cnki.MPM.202506289
正文
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人口老龄化一直是社会关注的热点。据国家统计局发布《中国统计年鉴》的人口抽样调查数据显示，截至2022年末，我国45~59岁中年群体占比24.2%，60岁及以上老年人口占比19.8%，由此可见到2030年老龄化程度将进一步加深[1]。然而，由于社会进步与观念转变，传统养老模式已无法适应现代家庭与社会发展的新趋势，老龄化加剧了经济压力与医疗负担[2-3]，因此满足中老年人长期照护需求、提高长期照护服务体系能力迫在眉睫。面对严峻的老龄化趋势，2022年2月，国务院印发《“十四五”国家老龄事业发展和养老服务体系规划》，强调要适应我国经济社会发展水平和老龄化发展趋势，建立基本养老服务清单制度，促进长期照护服务体系建设[4]。已有研究显示，长期照护服务相关研究主要聚焦于老年人或失能群体，尚未针对中年群体与老年群体，开展长期照护服务需求的比较分析[5-7]。基于此，本研究运用修正的安德森理论模型，旨在探究我国中老年人长期照护需求现状及其关键影响因素，为中老年人长期照护事业发展提供参考依据。
1　资料与方法
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1.1　资料来源
中国健康与养老追踪调查（China Health and Retirement Longitudinal Study，CHARLS），旨在研究我国45岁及以上中老年个体及家庭，该数据涵盖个人基本信息、家庭信息、健康状况与功能、工作与退休、收入与支出等模块，用以分析我国人口老龄化问题。本研究选取2020年CHARLS数据，经数据预处理剔除缺失样本后，最终纳入有效样本量为2 576人。
1.2　研究方法
本研究基于修正的安德森理论模型[8]，将45岁及以上中老年人群的长期照护需求类型作为因变量。将倾向特征（年龄、性别、婚姻状况、教育状况、居住地类型）、使能资源（退休金或工资、子女数量、子女联系频率）[9]、需求因素（有无患慢性病、健康状况）作为自变量[10]。鉴于已有文献指出，长期照护方式需求除客观因素影响外，还具有显著的主观性，易受代际关系、心理因素、社会支持、情感因素等多方面影响[11]，因此本研究纳入心理社会因素作为自变量，包括代际关系满意度、生活满意度、社交活动参与及抑郁倾向。
1.3　重要概念界定
①退休金和工资：退休金和工资为二分类变量，“无”赋值为0，“有”为1；②慢性病情况：包括高血压、血脂异常、糖尿病等14种慢性病，若患有至少一种慢性病，赋值为1，若未患病，赋值为0；③生活满意度：衡量调查问卷中“总体来看，您对自己的生活是否感到满意？”的回答，“一点也不满意”“不太满意”赋值为0；“比较满意”“非常满意”“极其满意”赋值为1。④代际关系满意度：衡量调查问卷中“您对您和您子女的关系满意吗？”的回答，“一点也不满意”“不太满意”赋值为0；“比较满意”“非常满意”“极其满意”赋值为1。⑤有无抑郁倾向：对调查问卷中的抑郁量表（CESD-10）进行评分，得分<10分，则判定为“无”，得分≥10分则判定为“有”。
1.4　统计学方法
使用Stata 16.0软件将2020年CHARLS数据整理、合并，运用SPSS 25.0开展统计分析。以倾向特征、使能资源、需求因素以及心理社会因素为自变量，长期照护需求类型为因变量，采用Fisher精确检验，并将检验结果中P<0.05的因素纳入无序多分类logistic回归模型进行进一步分析，以识别影响中老年人长期照护需求的关键因素。显著性水平α取0.05，P<0.05表示差异具有统计学意义。
2　结果
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2.1　调查对象基本情况
在2 576例有效样本中，倾向特征方面，男性1 389例（53.9%），女性1 187例（46.1%）；45~59岁占比最大（62.2%）；受教育程度初中及以下占比最大（81.7%）；婚姻状况为已婚占比最大（59.2%）；居住地类型为城镇占比43.0%。使能资源方面，有56.8%的样本人群没有退休金或工资；有两个子女的占比为44.7%；62.8%的样本人群与子女每月至少联系一次。需求方面，52.3%的样本人群不参与日常社交活动；未患慢性病的中老年人占比60.4%；自评健康状况为“好”的仅占比23.9%，“一般”则占比61.0%。心理社会因素方面，有91.3%的样本人群对生活表示不同程度的满意；96.0%对代际关系表示不同程度的满意；有24.3%的样本人群有抑郁倾向。详见表1。
2.2　中老年人长期照护需求单因素分析
分别以倾向特征、使能资源、需求以及心理社会因素为自变量，长期照护需求类型为因变量，采用Fisher精确检验，检验水准α取0.05，P<0.05为差异具有统计学意义。研究结果表明，在有效样本中，75.97%的中老年人倾向于居家长期照护，1.82%的中老年人倾向于养老院长期照护，1.05%的中老年人选择医院长期照护，21.16%的中老年人选择其他长期照护方式。通过Fisher精确检验，发现性别、年龄、婚姻状况、退休金或工资、有无慢性病、自评健康状况、社交活动参与和有无抑郁倾向等因素均能影响中老年人长期照护方式的选择。详见表1。
2.3　中老年人长期照护需求多元logistic回归分析
将Fisher精确检验结果中，具有统计学意义的倾向特征、使能资源、需求及心理社会因素作为自变量，中老年人长期照护需求类型作为因变量，将选择家庭长期照护方式的中老年人作为对照组，纳入无序多分类logistic回归模型。
研究结果显示，在倾向特征层面上，男性更倾向于选择养老院长期照护方式（OR=2.19，95% CI=1.16~4.12）和其他长期照护方式（OR=1.75，95% CI=1.37~2.22）。相对于45~59岁的中老年人群，75岁及以上的老年人群更倾向于医院长期照护方式（OR=3.80，95% CI=1.51~9.55）。离异的中老年群体更倾向于选择养老院长期照护方式（OR=23.62，95% CI=3.69~151.30）和医院长期照护方式（OR=8.82，95% CI=1.80~43.23）；丧偶的中老年群体更倾向于选择养老院长期照护方式（OR=43.70，95% CI=12.88~148.27）；其它婚姻状况的中老年群体倾向于选择养老院长期照护方式（OR=26.45，95% CI=7.50~93.35）、医院长期照护方式（OR=7.38，95% CI=3.15~17.27）和其他长期照护方式（OR=5.90，95% CI=4.66~7.47）。
在使能资源层面上，有退休金或工资的中老年群体更倾向于选择养老院的长期照护方式（OR=0.17，95% CI=0.06~0.51）和选择其他照护方式（OR=3.74，95% CI=2.93~4.77）。
在心理社会因素层面上，有社交活动参与的中老年群体更倾向于选择医院长期照护方式（OR=0.40，95% CI=0.18~0.89）和其他照护方式（OR=0.54，95% CI=0.43~0.67）。有抑郁倾向的中老年群体更倾向于选择养老院长期照护方式（OR=0.40，95% CI=0.14~0.91）。详见表2。
3　讨论
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本研究中，中老年人群长期照护需求分为家庭、养老院、医院以及其他方式。结果显示，75.97%的中老年人更倾向于居家照护方式，因此家庭长期照护方式的需求较大，这与已有研究结论一致[12]。
3.1　倾向特征对中老年人长期照护需求的影响
本研究结果显示，性别、年龄、婚姻状况对长期照护方式需求具有显著影响。女性更倾向于家庭长期照护方式，其原因在于受传统伦理道德观念、社会分工模式以及家庭结构形态等因素影响[13]，导致中老年女性表现出较强的家庭依赖性，进而更偏好于居家养老方式，与李爱等学者研究结论一致[14]。中年人群与60~74岁的老年人群更倾向于选择家庭长期照护方式，而75岁及以上的高龄老年人群更倾向于医院长期照护方式。其主要原因在于高龄老年人群体的医疗服务需求增加，长期照护情况相对复杂，医疗机构能提供专业且连续的医、护服务，满足其双重需求[15]。已婚的中老年人更倾向于家庭长期照护方式。原因在于家庭成员能够为他们提供生理和心理支持，满足其长期照护需求[16]。
3.2　使能资源对中老年人长期照护需求的影响
使能资源层面，退休金或工资对中老年人长期照护需求具有显著影响。具体而言，有退休金或工资的中老年人群体，更倾向于选择养老机构或其他方式。原因在于该群体具有相对稳定的收入来源和较高的收入水平，具备较强的经济独立性、支付能力与经济基础，从而能依据自身意愿自主选择长期照护方式[17]，并对非家庭长期照护方式持有更高的认可态度。相比之下，缺乏退休金或工资水平较低的中老年群体支付能力有限，难以获取高水平的非家庭长期照护服务。已有研究指出，子女数量、子女联系频率以及家庭养老支持程度等使能资源对长期照护需求存在显著影响[18]，然而，本研究未能得出相同结论，其原因可能在于本研究纳入了45~59岁中年人群，导致样本特征范围与既有研究存在不一致性，进而影响研究结果的呈现。
3.3　心理社会因素对中老年人长期照护需求的影响
心理社会因素层面，相较于没有参与日常社交活动的中老年人，有参与社交活动的更倾向于选择非家庭的长期照护方式，原因在于社交活动参与是中老年人情感与社会支持需求的重要影响因素[19]，对于存在日常社交活动障碍的中老年人而言，他们更容易产生社会孤立和疏离感，因此更偏向于选择家庭长期照护方式，与已有研究一致[20]。此外，有抑郁倾向的中老年人更倾向于选择养老机构长期照护方式，其原因在于，良好的机构养老服务质量能为该群体带来一定幸福感和安全感，从而提高其生活满意度与心理满意度，并满足其社交和自我尊严的需要。
综上所述，本研究系统分析了我国中老年人长期照护需求的影响因素。结果显示，我国中老年群体的长期照护需求受性别、年龄、婚姻状况、退休金或工资、社交活动参与、抑郁倾向等因素影响，在自主选择照护方式仍面临较大的局限性，主要原因在于：①受传统家庭观念影响，使其更倾向于选择家庭长期照护方式；②中年与老年群体经济基础与支付能力存在差异，导致长期护理保险的可承担水平参差不齐；③机构养老服务体系及相关政策制度尚不完善，机构长期照护服务发展相对滞后。因此，本研究提出以下建议：①加强长期照护服务制度的顶层设计，构建以法律法规为基础，辅以规章制度和规范性文件等政策的长期照护服务配套设施体系，补齐社会保障体系短板，并强化医养结合机制。②优化民政、卫生健康、医保等多部门协同管理机制，完善长期照护服务项目、标准及质量评价体系。③加大居家养老支持力度，整合医保支付等多元筹资方式，提供多层次长期照护服务，减轻支付能力较弱家庭的负担，推动具有中国特色的长期护理保险制度的建立与发展。
基金
收起
  • 教育部人文社科规划基金项目(21YJAZH016)
  • 四川省基层卫生事业发展研究中心重点项目(SWFZ24-Z-10)
  • 四川省中医药文化与中医药发展研究中心重点项目(ZYYWH2024010)
  • 四川省中医药管理局管理及决策项目(2023MS507)
  • 四川中医药大健康产业发展与乡村振兴研究中心重点项目(DJKWT202301)
  • 成都中医药大学杏林学者青基人才项目(QJRC2022056)
文献
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2025年第52卷第22期
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doi: 10.20043/j.cnki.MPM.202506289
  • 接收时间：2025-06-18
  • 首发时间：2026-10-29
  • 出版时间：2025-11-25
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  • 收稿日期：2025-06-18
基金
教育部人文社科规划基金项目(21YJAZH016)
四川省基层卫生事业发展研究中心重点项目(SWFZ24-Z-10)
四川省中医药文化与中医药发展研究中心重点项目(ZYYWH2024010)
四川省中医药管理局管理及决策项目(2023MS507)
四川中医药大健康产业发展与乡村振兴研究中心重点项目(DJKWT202301)
成都中医药大学杏林学者青基人才项目(QJRC2022056)
作者信息
    成都中医药大学管理学院，四川　成都　611137

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2种不同金属材料的力学参数
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Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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