河南省城乡居民卫生服务两周就诊率及影响因素分析  

Two-week consultation rate of health services in urban and rural area of Henan province and its influence factors

作　　者：朱继存[1] 闫梦青[1] 谢忱[1] 付珈珈 王璐[1] 张婉钰[2] 孙长青[1] 

机构地区：[1]郑州大学公共卫生学院社会医学与卫生事业管理学教研室,河南郑州450001 [2]郑州大学国际学院,河南郑州450001

出　　处：《现代预防医学》2016年第9期1606-1610,共5页Modern Preventive Medicine

基　　金：国家社会科学基金项目(15BSH043)

摘　　要：目的了解国家第五次卫生服务调查河南省城乡居民两周就诊率,并分析15岁及以上居民两周就诊的影响因素,为进一步优化卫生资源配置提供参考依据。方法运用分层整群随机抽样的方法,利用第五次国家卫生服务调查表,入户调查河南省居民家庭生活状况、人口学特征、两周病伤及就诊状况,采用多因素Logistic回归分析两周就诊的影响因素。结果河南省两周就诊率为11.7%,农村比城市高4.0%(x^2=127.213,P<0.05);随着年龄组的增高,城乡居民两周就诊率变化均呈先下降后上升趋势;无基本医疗保险的居民两周就诊率较低,为7.0%;两周患病首诊在基层卫生服务机构比例较大;农村居民因经济困难未就诊的比例比城市高3.1%(x^2=40.921,P<0.05);Logistic回归显示影响15岁及以上居民两周就诊的因素有城乡、年龄、就业状况、到最近医疗机构距离及是否为贫困户等。结论河南省农村卫生服务需求、利用较高,亟待提高城乡基本医疗保障服务均等化水平;相关部门应针对两周就诊的影响因素,采取有效措施提高卫生服务可及性。Objective To acquire the two - week consultation rate of the Fifth National Health Services Survey in Henan Province and analyze the influence factors of consultation in aged over 15 residents and provide a reference for optimizing the allocation of health resources. Methods The stratified cluster sampling method and questionnaire of the fifth national health services were used,and the life status, demographic characteristics, two - week prevalence and consultation in Henan Province were investigated in households. The influencing factors of consultation were analyzed by logistic regression. Results The two - week consultation rate in Henan Province was 11.7% ,and the countryside was 4% higher than the urban area （E2 = 127. 213, P 〈 O. 05 ）. With the increasing of age group,the two - week consultation rate of urban and rural residents both went down first and went up then. The two - week consultation rate of residents without basic medical insurance was low （7.0%）. Most residents chose primary health care institutions as the first diagnosed agencies. Residents who get no treatment in rural was 3. 1% higher than that in city area because of the economic hardship （X2 = 40. 921, P 〈 0. 05 ）. Logistic regression analysis was showed that urban or rural area, age, gender, medical institutions to the nearest distance and whether for poor households were the influencing factors of two - week consultation in aged over 15 residents. Conclusion The rural health service demand and utilization are high in Henan Province. The basic medical insurance service equalization level should be improved in rural and urban area imminently. The relevant departments should also take effective measures to improve the accessibility of health service according to the influence factors of two - week consultation.

关 键 词：河南省 卫生服务 两周就诊率 影响因素 

分 类 号：R195[医药卫生—卫生统计学]