不同残疾类型成年人的社会经济状况与康复服务利用的相关性
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摘要
目的分析社会经济状况对不同残疾类型成年残疾人使用康复服务的影响。方法选取第二次全国残疾人抽样调查中非多重残疾的成年残疾人数据,分析各类型残疾人中教育程度、人均家庭收入与康复服务利用的相关性,控制变量包括性别、年龄、城乡、婚姻状态和残疾等级。结果我国成年残疾人康复训练与服务的使用率为2.98%～15.97%。城镇各类残疾人康复训练与服务的使用率均高于乡村(χ2> 26.30, P <0.001)。多元回归显示,教育程度总体上是使用康复训练与服务的促进因素,但对不同类型残疾人影响不同;人均家庭收入在部分类型残疾人中是促进因素,部分类型残疾人中是阻碍因素,部分无显著影响。结论我国成年残疾人康复服务使用急需提升。影响成年残疾人使用康复服务的因素,不同类型残疾人有各自特点,应制定有针对性的政策,提升成年残疾人对康复服务的使用。
Objective To analyze the relationship between socio-economic status and utilization of rehabilitation services for adults with different disabilities.Methods Adults with single disability were selected from the Second China National Sample Survey on Disability. Their education level and per capita household income were used as socio-economic index, controlled with sex, age group, residence, disabled level and marriage.Results The prevalence of rehabilitation service utilization was 2.98% to 15.97%, and it was more in urban people than in rural ones. Education level trended to be a positive factor to utilization of rehabilitation service, but different with the types of disabilities. Per capita household income was mixed for the utilization of rehabilitation service,which was positive for some disabilities, negative for some ones, and no significant for others.Conclusion The utilization of rehabilitation services needs to improve for adults with disabilities. Policies can be made targeting to the people with different disabilities.
Objective To analyze the relationship between socio-economic status and utilization of rehabilitation services for adults with different disabilities.Methods Adults with single disability were selected from the Second China National Sample Survey on Disability. Their education level and per capita household income were used as socio-economic index, controlled with sex, age group, residence, disabled level and marriage.Results The prevalence of rehabilitation service utilization was 2.98% to 15.97%, and it was more in urban people than in rural ones. Education level trended to be a positive factor to utilization of rehabilitation service, but different with the types of disabilities. Per capita household income was mixed for the utilization of rehabilitation service,which was positive for some disabilities, negative for some ones, and no significant for others.Conclusion The utilization of rehabilitation services needs to improve for adults with disabilities. Policies can be made targeting to the people with different disabilities.
引文
[1]邱卓英,王博,刘智渊.国际功能、残疾和健康分类(ICF)及其应用研究[C]//2005中日脑瘫学术交流大会暨康复新技术论坛, 2005.
[2]世界卫生组织.国际功能、残疾与健康分类(国际中文增补版)[M].邱卓英,译.日内瓦:世界卫生组织, 2015.
[3]世界卫生组织,世界银行.世界残疾报告(国际中文版)[M].邱卓英,译.日内瓦:世界卫生组织, 2013.
[4]邱卓英,李欣,李沁燚,等.中国残疾人康复需求与发展研究[J].中国康复理论与实践, 2017, 23(8):869-874.
[5]张海迪.我国康复专业人才严重不足[EB/OL].(2017-03-15). http://www. cdpf. org. cn/ywzz/xcwh_263/gzdt_264/201703/t20170315_585622.shtml.
[6] Kinsella K, Victoria A V. An Aging World:2001[R]. Washington, D.C.:US Census Bureau, Series P95/01-1, 2001.
[7] Gimigliano F, Negrini S. The World Health Organization"Rehabilita‐tion 2030:a call for action"[J]. Eur J Phys Rehabil Med, 2017, 53(2):155.
[8]邱卓英,陈迪.发展卫生保健和康复服务,增进残疾人健康——学习?世卫组织2014~2021年全球残疾问题行动计划:增进所有残疾人的健康?[J].中国康复理论与实践, 2014, 20(7):611-615.
[9]李宁,陈功,崔斌,等.我国残疾人康复需求及康复服务利用情况分析[J].残疾人研究, 2011(4):31-34.
[10]张海迪.康复是残疾人小康最迫切需求[EB/OL].(2016-03-09).http://www.cdpf.org.cn/yw/201603/t20160309_543404.shtml.
[11]刘保芬,严秀群,段清萍,等.社区残疾人康复服务的影响因素与对策[J].护理实践与研究, 2012, 9(14):155-156.
[12]谷长芬,李勇,梁爱民,等.北京市智力残疾儿童康复影响因素的Lo‐gistic回归分析[J].中国康复理论与实践, 2009, 15(2):185-187.
[13] Ranjbar Ezzatabadi M, Khosravi A, Bahrami M A, et al. Socio-eco‐nomic inequalities in health services utilization:a cross sectional study[J]. Int J Health Care Qual Assurance, 2018, 31(1):69-75.
[14] Hindhede A L, Bonde A, Schipperijn J, et al. How do socio-econom‐ic factors and distance predict access to prevention and rehabilitation services in a Danish municipality?[J]. Prim Health Care Res Dev,2016, 17(6):578-585.
[15] Donisi V, Tedeschi F, Percudani M, et al. Prediction of community mental health service utilization by individual and ecological level so‐cio-economic factors[J]. Psychiatry Res, 2013, 209(3):691-698.
[16]罗遐,卜普.农村残疾人接受康复治疗行为的影响因素研究[J].安徽大学学报(哲学社会科学版), 2013, 37(4):128-134.
[17]杜鹏,杨慧.中国老年残疾人口状况与康复需求[J].首都医科大学学报, 2008, 29(3):262-265.
[18] Pfeiffer D. The influence of the socio-economic characteristics of dis‐abled people on their employment status and income[J]. Disabil Soc,1991, 6(2):103-114.
[19]郑晓瑛,孙喜斌,刘民,等.中国残疾预防对策研究[M].北京:华夏出版社, 2008.
[20] Elrod C S, Dejong G. Determinants of utilization of physical rehabili‐tation services for persons with chronic and disabling conditions:an ex‐ploratory study[J]. Arch Phys Med Rehabil, 2008, 89(1):114-120.
[21]施继良,彭虹,魏志云,等.北京市六类残疾人康复需求现状分析[C]//北京市残疾人康复学术研讨会, 2008.
[22] Rosenheck R, Mueser K T, Sint K, et al. Supported employment and education in comprehensive, integrated care for first episode psychosis:effects on work, school, and disability income[J]. Schizophr Res, 2017,182:120-128.
[23] Butler L N, Sheppard-Jones K, Whaley B, et al. Does participation in higher education make a difference in life outcomes for students with intellectual disability?[J]. J Voct Rehabil, 2015, 44(3):295-298.
[24]张金明,赵悌尊.对我国残疾儿童康复的思考[J].中国康复理论与实践, 2012, 18(2):193-196.
[25]张蕾,姜桂平,陈功,等.成年精神残疾人分层服务需求满足的关联因素[J].中国心理卫生杂志, 2014, 28(10):741-747.
[26] McColl M A. Disability studies at the population level:issues of health service utilization[J]. Am J Occup Ther, 2005, 59(5):516.
[27]刘宝松,裴曌,郭咏军,等.上海市成年肢体残疾人整体康复需求实现程度及相关因素分析[J].中国康复理论与实践, 2017, 23(8):883-886.
[28] van der Heide I, Wang J, Droomers M, et al. The relationship be‐tween health, education, and health literacy:results from the Dutch Adult Literacy and Life Skills Survey[J]. J Health Commun, 2013, 18(Suppl 1):172-184.
[29] Kickbusch I S. Health literacy:addressing the health and education divide[J]. Health Promot Int, 2001, 16(3):289-297.
[30] Gupta V K, Winter M, Cabral H, et al. Disparities in age-associated cognitive decline between African-American and Caucasian popula‐tions:the roles of health literacy and education[J]. J Am Geriatr Soc,2016, 64(8):1716-1723.
[31] Frier A, Barnett F, Devine S. The relationship between social deter‐minants of health, and rehabilitation of neurological conditions:a sys‐tematic literature review[J]. Disabil Rehabil, 2016, 39(10):1-8.
[32] Rosenbach M L. Access and satisfaction within the disabled medi‐care population[J]. Health Care Financ Rev, 1995, 17(2):147-167.
[33]刘飞跃,曾望军,陈艳.我国精神卫生服务网点空间布局现状、困境与突破[J].中国卫生政策研究, 2011, 4(3):28-32.
[34]胡向阳,张珊,张钧,等.我国伤害致残人群康复服务需求及利用情况分析[J].伤害医学:电子版, 2014, 3(1):27-34.
[35] World Health Organization. Rehabilitation 2030:A Call for Action[R]. Geneva:World Health Organization, 2017.
[2]世界卫生组织.国际功能、残疾与健康分类(国际中文增补版)[M].邱卓英,译.日内瓦:世界卫生组织, 2015.
[3]世界卫生组织,世界银行.世界残疾报告(国际中文版)[M].邱卓英,译.日内瓦:世界卫生组织, 2013.
[4]邱卓英,李欣,李沁燚,等.中国残疾人康复需求与发展研究[J].中国康复理论与实践, 2017, 23(8):869-874.
[5]张海迪.我国康复专业人才严重不足[EB/OL].(2017-03-15). http://www. cdpf. org. cn/ywzz/xcwh_263/gzdt_264/201703/t20170315_585622.shtml.
[6] Kinsella K, Victoria A V. An Aging World:2001[R]. Washington, D.C.:US Census Bureau, Series P95/01-1, 2001.
[7] Gimigliano F, Negrini S. The World Health Organization"Rehabilita‐tion 2030:a call for action"[J]. Eur J Phys Rehabil Med, 2017, 53(2):155.
[8]邱卓英,陈迪.发展卫生保健和康复服务,增进残疾人健康——学习?世卫组织2014~2021年全球残疾问题行动计划:增进所有残疾人的健康?[J].中国康复理论与实践, 2014, 20(7):611-615.
[9]李宁,陈功,崔斌,等.我国残疾人康复需求及康复服务利用情况分析[J].残疾人研究, 2011(4):31-34.
[10]张海迪.康复是残疾人小康最迫切需求[EB/OL].(2016-03-09).http://www.cdpf.org.cn/yw/201603/t20160309_543404.shtml.
[11]刘保芬,严秀群,段清萍,等.社区残疾人康复服务的影响因素与对策[J].护理实践与研究, 2012, 9(14):155-156.
[12]谷长芬,李勇,梁爱民,等.北京市智力残疾儿童康复影响因素的Lo‐gistic回归分析[J].中国康复理论与实践, 2009, 15(2):185-187.
[13] Ranjbar Ezzatabadi M, Khosravi A, Bahrami M A, et al. Socio-eco‐nomic inequalities in health services utilization:a cross sectional study[J]. Int J Health Care Qual Assurance, 2018, 31(1):69-75.
[14] Hindhede A L, Bonde A, Schipperijn J, et al. How do socio-econom‐ic factors and distance predict access to prevention and rehabilitation services in a Danish municipality?[J]. Prim Health Care Res Dev,2016, 17(6):578-585.
[15] Donisi V, Tedeschi F, Percudani M, et al. Prediction of community mental health service utilization by individual and ecological level so‐cio-economic factors[J]. Psychiatry Res, 2013, 209(3):691-698.
[16]罗遐,卜普.农村残疾人接受康复治疗行为的影响因素研究[J].安徽大学学报(哲学社会科学版), 2013, 37(4):128-134.
[17]杜鹏,杨慧.中国老年残疾人口状况与康复需求[J].首都医科大学学报, 2008, 29(3):262-265.
[18] Pfeiffer D. The influence of the socio-economic characteristics of dis‐abled people on their employment status and income[J]. Disabil Soc,1991, 6(2):103-114.
[19]郑晓瑛,孙喜斌,刘民,等.中国残疾预防对策研究[M].北京:华夏出版社, 2008.
[20] Elrod C S, Dejong G. Determinants of utilization of physical rehabili‐tation services for persons with chronic and disabling conditions:an ex‐ploratory study[J]. Arch Phys Med Rehabil, 2008, 89(1):114-120.
[21]施继良,彭虹,魏志云,等.北京市六类残疾人康复需求现状分析[C]//北京市残疾人康复学术研讨会, 2008.
[22] Rosenheck R, Mueser K T, Sint K, et al. Supported employment and education in comprehensive, integrated care for first episode psychosis:effects on work, school, and disability income[J]. Schizophr Res, 2017,182:120-128.
[23] Butler L N, Sheppard-Jones K, Whaley B, et al. Does participation in higher education make a difference in life outcomes for students with intellectual disability?[J]. J Voct Rehabil, 2015, 44(3):295-298.
[24]张金明,赵悌尊.对我国残疾儿童康复的思考[J].中国康复理论与实践, 2012, 18(2):193-196.
[25]张蕾,姜桂平,陈功,等.成年精神残疾人分层服务需求满足的关联因素[J].中国心理卫生杂志, 2014, 28(10):741-747.
[26] McColl M A. Disability studies at the population level:issues of health service utilization[J]. Am J Occup Ther, 2005, 59(5):516.
[27]刘宝松,裴曌,郭咏军,等.上海市成年肢体残疾人整体康复需求实现程度及相关因素分析[J].中国康复理论与实践, 2017, 23(8):883-886.
[28] van der Heide I, Wang J, Droomers M, et al. The relationship be‐tween health, education, and health literacy:results from the Dutch Adult Literacy and Life Skills Survey[J]. J Health Commun, 2013, 18(Suppl 1):172-184.
[29] Kickbusch I S. Health literacy:addressing the health and education divide[J]. Health Promot Int, 2001, 16(3):289-297.
[30] Gupta V K, Winter M, Cabral H, et al. Disparities in age-associated cognitive decline between African-American and Caucasian popula‐tions:the roles of health literacy and education[J]. J Am Geriatr Soc,2016, 64(8):1716-1723.
[31] Frier A, Barnett F, Devine S. The relationship between social deter‐minants of health, and rehabilitation of neurological conditions:a sys‐tematic literature review[J]. Disabil Rehabil, 2016, 39(10):1-8.
[32] Rosenbach M L. Access and satisfaction within the disabled medi‐care population[J]. Health Care Financ Rev, 1995, 17(2):147-167.
[33]刘飞跃,曾望军,陈艳.我国精神卫生服务网点空间布局现状、困境与突破[J].中国卫生政策研究, 2011, 4(3):28-32.
[34]胡向阳,张珊,张钧,等.我国伤害致残人群康复服务需求及利用情况分析[J].伤害医学:电子版, 2014, 3(1):27-34.
[35] World Health Organization. Rehabilitation 2030:A Call for Action[R]. Geneva:World Health Organization, 2017.