《保险研究》20251205-《中国老年人口无失能预期寿命演变及其分解研究》（汤薇、粟芳）

［摘   要］本文基于中国老年健康影响因素跟踪调查2002～2018年纵向数据，构建65岁及以上老年人四状态连续时间马尔科夫模型，采用多状态生命表方法计算基于状态的预期寿命和基于人群的预期寿命，运用Horiuchi连续变化分解技术量化了九种不同健康状态转移概率对无失能预期寿命变化的影响。研究发现：健康状态转移概率具有显著的年龄依赖性和功能状态分层效应；失能转移在2002～2008年期间具有指数增长规律；功能恢复转移呈现出明显的时期差异；总预期寿命在所有年龄组均有延长，但健康占比具有显著的性别-年龄差异；死亡率改善，特别是健康人群死亡率改善，是缓解无失能预期寿命下降的最重要因素，65岁群体的贡献最大(女性约0.049年、男性约0.038年)并随年龄递减；健康向轻度失能转换恶化是推动无失能预期寿命下降的核心驱动力，在65~75岁群体产生最显著负向影响，女性所受冲击几乎是男性的两倍。中国老年人健康预期寿命演变遵循年龄-性别分层模式，女性呈现“高波动性”健康转型特征，男性呈现“低强度持久性”健康转型轨迹，需采取差异化的政策干预，并完善健康政策框架以应对女性群体的失能扩张风险和男性群体的渐进式健康转型特征。

［关键词］无失能预期寿命；多状态生命表；连续变化分解；连续时间马尔科夫模型

［基金项目］国家自然科学基金青年项目“基于失能老人居住安排的长期护理需求预测研究”(72404016)；博士后第 76 批面上基金项目(2024M760039)。

［作者简介］汤薇，华南师范大学政治与公共管理学院副研究员；粟芳，上海财经大学金融学院教授。

Evolution and Decomposition of Disability-free Life Expectancy among Chinese Elder Adults

TANG Wei，SU Fang

Abstract：This study constructed a four-state continuous-time Markov model for adults aged 65 and above using longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (2002-2018).Multistate life table methods were employed to calculate state-based life expectancy and population-based life expectancy and their components，and Horiuchi continuous-change decomposition techniques were applied to quantify the contributions of nine different health states transition probabilities to changes in disability-free life expectancy.Results show that health state transition probabilities exhibit significant age dependence and functional status stratification effects.Disability transitions follow exponential growth patterns;functional recovery transitions demonstrate significant time period characteristics.Total life expectancy increases across all age groups，but health proportion exhibits significant gender-age differential patterns.Mortality improvement (particularly healthy population mortality improvement) constitutes the most important force in mitigating disability-free life expectancy decline，contributing maximally by the 65-year-old group (approximately 0.049 years for women，0.038 years for men) and decreasing with age;healthy-to-mild disability transition deterioration serves as the core driving force pushing disability-free life expectancy decline，producing the most significant negative impacts in the 65-75 age group，with women experiencing nearly twice the impact as men.The evolution of healthy life expectancy among Chinese elder adults follows age-gender stratified patterns，with women exhibiting “high volatility” health transition characteristics and men demonstrating “low-intensity persistent” trajectories，requiring differentiated policy interventions and improved health policy frameworks to address disability expansion risks in women and gradual health transition characteristics in men.

Key words：disability-free life expectancy;multistate life table;continuous-change decomposition;continuous-time Markov model