青年流动人口基本公共卫生服务利用及影响因素分析
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摘要
目的了解青年流动人口基本公共卫生服务的利用现状及其影响因素,为制定青年流动人口健康保障相关政策提供依据。方法采用2014年全国流动人口卫生计生动态监测数据中的29 281名15～24岁青年人群资料,用分层线性回归模型和logistic回归对青年流动人口基本公共卫生服务利用及影响因素进行分析。结果青年流动人口基本公共卫生服务利用总体水平较低,15～24岁的青年流动人口中只有18.0%的人建立健康档案;28.5%的人接受过职业病防治的健康教育,分别有43.0%、22.6%的人接受过艾滋病防治和结核病防治的健康教育,分别有38.4%和31.6%的人接受过生殖与避孕和性病防治的健康教育;多因素分析显示,青年流动人口基本公共卫生服务利用的影响因素为性别(OR=1.101)、年龄(OR=1.153)、文化程度(OR=0.937)、婚姻状况(OR=1.300)、单位性质(国企OR=1.666、外企OR=1.494;私企及其他等OR <1)、流动地区(OR=2.132、2.716、2.248)、是否有长期居住打算(否、没想好OR <1)、是否有医疗保险(OR=1.704)。结论青年流动人口对基本公共卫生服务可及性差,应加强健康教育的宣传,重视青年流动人口的职业病防治、性别防治、生殖保健方面的健康教育。
Objective To explore the utilization of basic public health services(BPHS) and its influence factors among young migrants. Methods We extracted the data on 29 281 migrants aged 15 – 24 years from the National Dynamic Surveillance on Health and Family Planning for Migrant Population conducted in May 2014. Hierarchical linear regression model and multivariate logistic regression model were used to examine the influence factors of BPHS utilization in the participants. Results The utilization of BPHS was generally at a low level among the participants. For all the participants,only 18% had their health records established; 28.5%, 43.0%, and 31.6% reported having received health education on prevention of occupational disease, AIDS, and sexually transmitted diseases; and 38.4% reported having received health education on reproduction and contraception. Multivariate analyses revealed following significant impact factors for BPHS utilization of the participants: gender(female vs. male: odds ratio [OR] = 1.101), age(18 – 24 vs. 15 – 17: OR = 1.153),education(junior high school vs. primary school or lower: OR = 0.937), marital status(married vs. unmarried: OR = 0.937),employment(governmental or public institution vs. state-owned enterprise/foreign enterprise, privat enterprise and other employment: OR = 1.666/1.494, OR < 1), region of migration(central/northeastern/western vs. eastern: OR < 1), willingness to stay in the region of migration for a long time(yes vs. no or uncertain: OR < 1), and whether having medical insurance(yes vs. no: OR = 1.704). Conclusion The accessibility of basic public health services for young migrants is poor; the result suggests that health education should be strengthened in the population.
Objective To explore the utilization of basic public health services(BPHS) and its influence factors among young migrants. Methods We extracted the data on 29 281 migrants aged 15 – 24 years from the National Dynamic Surveillance on Health and Family Planning for Migrant Population conducted in May 2014. Hierarchical linear regression model and multivariate logistic regression model were used to examine the influence factors of BPHS utilization in the participants. Results The utilization of BPHS was generally at a low level among the participants. For all the participants,only 18% had their health records established; 28.5%, 43.0%, and 31.6% reported having received health education on prevention of occupational disease, AIDS, and sexually transmitted diseases; and 38.4% reported having received health education on reproduction and contraception. Multivariate analyses revealed following significant impact factors for BPHS utilization of the participants: gender(female vs. male: odds ratio [OR] = 1.101), age(18 – 24 vs. 15 – 17: OR = 1.153),education(junior high school vs. primary school or lower: OR = 0.937), marital status(married vs. unmarried: OR = 0.937),employment(governmental or public institution vs. state-owned enterprise/foreign enterprise, privat enterprise and other employment: OR = 1.666/1.494, OR < 1), region of migration(central/northeastern/western vs. eastern: OR < 1), willingness to stay in the region of migration for a long time(yes vs. no or uncertain: OR < 1), and whether having medical insurance(yes vs. no: OR = 1.704). Conclusion The accessibility of basic public health services for young migrants is poor; the result suggests that health education should be strengthened in the population.
引文
[1]国家卫生和计划生育委员会流动人口司.中国流动人口发展报告2017[M].北京:中国人口出版社,2017.
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[5]Li X,Fang X,Lin D,et al.HIV/STD risk behaviors and perceptions among rural-to-urban migrants in China[J].Aids Education and Prevention,2004,16(6):538-556.
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[7]宋月萍,李龙.流动人口健康档案现状调查分析[J].档案学通讯,2015(3):84-88.
[8]中共中央国务院.国家基本公共服务体系“十二五规划”[EB/OL].[2018-04-08].http://www.gov.cn/zwgk/2012-07/20/content_2187242.htm.
[9]孙昕霙,史宇晖,纪颖,等.天津、陕西两省市青年流动人口生殖健康及避孕现状调查[J].中国计划生育学杂志,2011,19(1):22-25.
[10]杨昕.户籍与流动人口基本公共卫生服务利用差异及影响因素[J].中国公共卫生,2018,34(6):781-785.
[11]张庆武.青年流动人口社会融入测量与实证研究[D].北京:北京交通大学.2017.
[12]郭静,邵飞,范慧,等.流动人口基本公共卫生服务可及性及影响因素分析[J].中国卫生政策研究,2016,9(8):75-82.
[13]徐嘉,张磊,周令,等.大连市流动人口卫生服务可及性及影响因素分析[J].中国卫生经济,2014,33(7):72-74.
[14]袁雁飞,纪颖,蒋莹,等.某市15~24岁青年流动人口卫生服务利用及其影响因素[J].北京大学学报:医学版,2012,44(4):602-606.
[15]龙俊睿,郭蕊,李胜伟,等.北京市外来务工人员公共卫生服务利用调查[J].中国公共卫生,2014,30(8):998-1001.
[16]纪颖,袁雁飞,栗潮阳,等.流动人口与农村青年人口健康状况及卫生服务利用的比较分析[J].人口学刊,2013(2):90-96.
[2]国家卫生和计划生育委员会流动人口司.中国流动人口发展报告2015[M].北京:中国人口出版社,2015.
[3]胡连鑫,陈燕燕.我国流动人口的公共卫生现状[J].现代预防医学,2007,34(1):96-98.
[4]周建波,张秀军,孙业桓,等.中国流动人口性病/艾滋病的流行现状及预防控制[J].国际流行病学传染病学杂志,2006,33(6):425-428.
[5]Li X,Fang X,Lin D,et al.HIV/STD risk behaviors and perceptions among rural-to-urban migrants in China[J].Aids Education and Prevention,2004,16(6):538-556.
[6]国家卫生和计划生育委员会流动人口司.中国流动人口发展报告2016[M].北京:中国人口出版社,2016.
[7]宋月萍,李龙.流动人口健康档案现状调查分析[J].档案学通讯,2015(3):84-88.
[8]中共中央国务院.国家基本公共服务体系“十二五规划”[EB/OL].[2018-04-08].http://www.gov.cn/zwgk/2012-07/20/content_2187242.htm.
[9]孙昕霙,史宇晖,纪颖,等.天津、陕西两省市青年流动人口生殖健康及避孕现状调查[J].中国计划生育学杂志,2011,19(1):22-25.
[10]杨昕.户籍与流动人口基本公共卫生服务利用差异及影响因素[J].中国公共卫生,2018,34(6):781-785.
[11]张庆武.青年流动人口社会融入测量与实证研究[D].北京:北京交通大学.2017.
[12]郭静,邵飞,范慧,等.流动人口基本公共卫生服务可及性及影响因素分析[J].中国卫生政策研究,2016,9(8):75-82.
[13]徐嘉,张磊,周令,等.大连市流动人口卫生服务可及性及影响因素分析[J].中国卫生经济,2014,33(7):72-74.
[14]袁雁飞,纪颖,蒋莹,等.某市15~24岁青年流动人口卫生服务利用及其影响因素[J].北京大学学报:医学版,2012,44(4):602-606.
[15]龙俊睿,郭蕊,李胜伟,等.北京市外来务工人员公共卫生服务利用调查[J].中国公共卫生,2014,30(8):998-1001.
[16]纪颖,袁雁飞,栗潮阳,等.流动人口与农村青年人口健康状况及卫生服务利用的比较分析[J].人口学刊,2013(2):90-96.