成都市城乡老年人卫生服务需求与利用分析
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摘要
目的了解成都市城乡老年人卫生服务需求与利用的现状及其影响因素,为卫生政策和规划的制定提供科学依据。方法通过多阶段抽样,对锦江区和邛崃市乡镇23 228名60岁及以上的老年人进行问卷调查。统计分析采用t检验、χ~2检验和二分类logistic回归。结果被调查城乡老年人两周患病率分别为34. 8%和27. 0%,慢性病患病率为46. 8%和36. 9%;两周就诊率为28. 8%和23. 3%,超过半数的城乡老年人选择社区卫生服务中心或乡镇卫生院就诊,主要原因是距离近,两周患病未就诊率为17. 3%和28. 5%,未就诊的原因主要是进行了自我医疗和自感病轻;女性、高龄、单身(未婚、离婚或丧偶)是城乡老年人两周患病的主要危险因素,OR值分别为1. 174(1. 083,1. 271)、1. 841(1. 648,2. 057)、1. 126(0. 983,1. 290),1. 193(1. 100,1. 294)、1. 316(1. 205,1. 436)、1. 573(1. 012,2. 433);两周就诊的主要危险因素同上,OR值分别为1. 129(1. 037,1. 228)、1. 775(1. 580,1. 993)、1. 240(1. 074,1. 433),1. 096(1. 007,1. 194)、1. 282(1. 169,1. 406)、1. 271(1. 133,1. 426)。结论成都市城乡老年人卫生服务需求较高,但利用不充分,农村低利用的情况更为明显。老年人卫生服务工作应以女性、高龄、单身者为重点。
Objective To understand the current situation and influence factors of health service demand and utilization among the elderly in urban and rural areas of Chengdu city,and to provide scientific evidence for making health policy and planning.Methods A total of 23 228 elderly people over 60 years old from Jinjiang and Qionglai were investigated by the cross-sectional survey with multistage sampling.The t-test,chi-square test and binary logistic regression were used for statistical analysis.Results The two-week prevalence rates among the elderly in urban and rural areas were 34.8% and 27.0%,the prevalence rates of chronic diseases were 46.8% and 36.9%,the two-week consultation rate were 28.8% and 23.3% in urban and rural areas,respectively.More than half of the elderly went to the community healthcare centers and township health centers to visit hospital and the major factor was the short distance.17.3% and 28.5% patients did not visit hospital mainly due to self-therapy or the mild illness.The risk factors of two-week prevalence and consultation rate among the elderly were female,advanced age and single(unmarried,divorced or widowed).OR values were 1.174(1.083,1.271),1.841(1.648,2.057),1.126(0.983,1.290),1.193(1.100,1.294),1.316(1.205,1.436),1.573(1.012,2.433),1.129(1.037,1.228),1.775(1.580,1.993),1.240(1.074,1.433),1.096(1.007,1.194),1.282(1.169,1.406),1.271(1.133,1.426),respectively.Conclusion Great demand exists in the health service of the elderly in Chengdu city,while the utilization is inadequate,especially in rural area.Health services for the elderly should be focused on female,senior citizens and singles.
Objective To understand the current situation and influence factors of health service demand and utilization among the elderly in urban and rural areas of Chengdu city,and to provide scientific evidence for making health policy and planning.Methods A total of 23 228 elderly people over 60 years old from Jinjiang and Qionglai were investigated by the cross-sectional survey with multistage sampling.The t-test,chi-square test and binary logistic regression were used for statistical analysis.Results The two-week prevalence rates among the elderly in urban and rural areas were 34.8% and 27.0%,the prevalence rates of chronic diseases were 46.8% and 36.9%,the two-week consultation rate were 28.8% and 23.3% in urban and rural areas,respectively.More than half of the elderly went to the community healthcare centers and township health centers to visit hospital and the major factor was the short distance.17.3% and 28.5% patients did not visit hospital mainly due to self-therapy or the mild illness.The risk factors of two-week prevalence and consultation rate among the elderly were female,advanced age and single(unmarried,divorced or widowed).OR values were 1.174(1.083,1.271),1.841(1.648,2.057),1.126(0.983,1.290),1.193(1.100,1.294),1.316(1.205,1.436),1.573(1.012,2.433),1.129(1.037,1.228),1.775(1.580,1.993),1.240(1.074,1.433),1.096(1.007,1.194),1.282(1.169,1.406),1.271(1.133,1.426),respectively.Conclusion Great demand exists in the health service of the elderly in Chengdu city,while the utilization is inadequate,especially in rural area.Health services for the elderly should be focused on female,senior citizens and singles.
引文
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[2] 成都市老龄工作委员会办公室.成都市2017年老年人口信息和老龄事业发展状况报告[R].成都:四川省老龄工作委员会办公室,2018.
[3] 国家卫生计生委统计信息中心.2013第五次国家卫生服务调查分析报告[EB/OL].[2019-05-15].http://www.nhfpc.gov.cn/mohwsbwstjxxzx/s8211/201610/9f109ff40e9346fca76dd82cecf419ce.shtml.
[4] 慕晓,田庆丰,孙锦峰,等.丹江口库区过渡期移民卫生服务需求及利用状况调查[J].中华疾病控制杂志,2014,18(2):155-158.
[5] 邓阳,朱云芳,陈怡蓉,等.昆明市某县农村留守老人卫生服务需求、利用及影响因素分析[J].昆明医科大学学报,2014,35(7):50-53.
[6] 翟景花,宋爱芹,郭立燕,等.老年人卫生服务需求与利用及其影响因素分析[J].济宁医学院学报,2014(6):420-424.
[7] 赵明月,杨付英,孔凡磊,等.山东省农村老年人卫生服务需求与利用现况分析[J].中国卫生事业管理,2017,34(2):131-133.
[8] 翟景花,杨海霞,宋爱芹,等.空巢老人卫生服务需求与利用及其影响因素的研究[J].中国卫生事业管理,2015,32(4):306-309.
[9] 龚剑,祝墡珠,潘志刚,等.上海市外来务工人员卫生服务需求和利用现状调查研究[J].中国全科医学,2015(1):93-99,104.
[10] 何莎莎,危莉,冯占春.均等化目标下我国农村老年人利用基本公共卫生服务的影响因素分析[J].中国卫生经济,2012,31(8):42-44.
[11] 李媛,乔慧,高忠飞,等.宁夏农村老年人卫生服务需求与利用现状[J].中国公共卫生,2017,33(4):548-552.