福建省流动人口门诊需求行为及影响因素分析
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摘要
目的通过对福建省流动人口的门诊医疗需求、门诊医疗服务利用现状及其影响因素的分析,为提高流动人口的健康水平,促进基本公共卫生服务均等化提供参考依据。方法基于2017年全国流动人口动态监测调查数据福建省资料,利用STATA 12.0软件进行统计分析。结果 2016年5—2017年5月,福建省6 999名流动人口调查对象患病后的就诊率为61.92%(2 492/4 025),选择在本地个体诊所就诊的比例最大、为23.85%(960/4 025);相对于家庭月收入≤5 000元的人群,5 001～10 000元(P=0.011)和> 10 000元(P=0.009)的人群患病后就诊的可能性更大;新型农村合作医疗保险的参加情况为是否就诊(P <0.001)和就诊地点选择(P=0.004)的双重影响因素,而参加城镇医疗保险的流动人口可能存在过度利用的情况(P=0.030)。结论流动人口门诊医疗服务利用不充分,家庭月收入、医疗保险的参加以及受教育程度是门诊服务利用的重要制约因素。
Objective To examine the demand for and utilization of outpatient services and their influencing factors among migrant population in Fujian province and to provide evidences for promoting health of the population and equalization of basic public health care. Methods We extracted the information on 6 999 migrant people aged 15 – 80 years in Fujian province from the dataset of China Migrants Dynamic Survey conducted in May 2017 and analyzed the data using STATA 12.0 statistical software. Results Among all the participants, 4025(57.51%) reported the history of disease or perceived illness over the previous one year. Of the participants with the history of disease or perceived illness, 61.92%(n =2 492) sought a medical services and 23.85%(n = 960) visited a doctor in local private clinics. The results of regression analysis indicated that the participants with the monthly family income of 5 001 – 10 000 yuan(RMB) and more were more likely to seek medical service when having disease or perceived illness compared to those with the income of ≤5 000 yuan(P = 0.009 and P = 0.011); whether participating in New Rural Cooperative Medical Scheme was a significant influencing factor for seeking medical service(P < 0.001) and selection of type of health care institutions(P = 0.004) when having disease or perceived illness; while, the participants participating in medical insurance for urban residents were more likely to have over-utilization of medical service(P = 0.030). Conclusion The utilization of outpatient medical service is insufficient and mainly influenced by monthly family income, participation of medical insurance, and education level among migrant population in Fujian province.
Objective To examine the demand for and utilization of outpatient services and their influencing factors among migrant population in Fujian province and to provide evidences for promoting health of the population and equalization of basic public health care. Methods We extracted the information on 6 999 migrant people aged 15 – 80 years in Fujian province from the dataset of China Migrants Dynamic Survey conducted in May 2017 and analyzed the data using STATA 12.0 statistical software. Results Among all the participants, 4025(57.51%) reported the history of disease or perceived illness over the previous one year. Of the participants with the history of disease or perceived illness, 61.92%(n =2 492) sought a medical services and 23.85%(n = 960) visited a doctor in local private clinics. The results of regression analysis indicated that the participants with the monthly family income of 5 001 – 10 000 yuan(RMB) and more were more likely to seek medical service when having disease or perceived illness compared to those with the income of ≤5 000 yuan(P = 0.009 and P = 0.011); whether participating in New Rural Cooperative Medical Scheme was a significant influencing factor for seeking medical service(P < 0.001) and selection of type of health care institutions(P = 0.004) when having disease or perceived illness; while, the participants participating in medical insurance for urban residents were more likely to have over-utilization of medical service(P = 0.030). Conclusion The utilization of outpatient medical service is insufficient and mainly influenced by monthly family income, participation of medical insurance, and education level among migrant population in Fujian province.
引文
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[8]刘菂,代涛,黄菊.中国2011-2015年居家失能老年人医疗服务需求及利用情况分析[J].中国公共卫生,2018,34(5):687-689.
[9]胡健,武飚,武学丽,等.苗族村寨留守老年患者门诊服务利用及影响因素分析[J].中国公共卫生,2012,28(9):1176-1178.
[10]徐曼周令,陈麒,盛立英,等.大连市居民门诊服务需要与需求分析[J].中国公共卫生,2014,30(9):1207-1209.
[11]凌莉,刘军,韩璐,等.广州市农村流动人口卫生服务需求与利用分析[J].华南预防医学,2006,32(2):1-4.
[2]曾智,陈雯,夏英华,等.广州市户籍人口与流动人口就医行为差异及影响因素分析[J].中国卫生事业管理,2012,29(6):417-419.
[3]江婷婷,赵颖智,石智雷.流动人口就医行为及公共卫生服务利用质量分析?--基于湖北省2013年流动人口动态监测调查[J].宏观质量研究,2015(1):111-119.
[4]陈卫建,吴文君.杭州市拱墅区流动人口卫生服务需求现状调查[J].现代预防医学,2007,34(4):789.
[5]陈金喜,夏挺松,胡晓霞,等.深圳市流动人口社区卫生服务利用及其影响因素分析[J].中国全科医学,2005,8(19):1638-1640.
[6]马杰,温静,任彬彬,等.农村居民两周患病未就诊原因及影响因素分析[J].中国公共卫生,2010,26(5):551-552.
[7]韩华为.中老年患者门诊需求行为及其决定因素--来自浙江、甘肃两省的经验证据[J].中国人口科学,2010(5):75-84.
[8]刘菂,代涛,黄菊.中国2011-2015年居家失能老年人医疗服务需求及利用情况分析[J].中国公共卫生,2018,34(5):687-689.
[9]胡健,武飚,武学丽,等.苗族村寨留守老年患者门诊服务利用及影响因素分析[J].中国公共卫生,2012,28(9):1176-1178.
[10]徐曼周令,陈麒,盛立英,等.大连市居民门诊服务需要与需求分析[J].中国公共卫生,2014,30(9):1207-1209.
[11]凌莉,刘军,韩璐,等.广州市农村流动人口卫生服务需求与利用分析[J].华南预防医学,2006,32(2):1-4.
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