宁夏海原县农村学龄前儿童卫生服务利用的公平性研究  

Study on the Equity of Health Service Utilization for Preschool Children in Rural Areas of Ningxia Haiyuan County

作　　者：谢永鑫 乔慧 程旺 陈蕾 XIE Yongxin;QIAO Hui;CHENG Wang;CHEN Lei(Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University,Yinchuan 750004)

机构地区：[1]宁夏医科大学公共卫生与管理学院,银川750004

出　　处：《宁夏医科大学学报》2018年第12期1380-1383,1394,共5页Journal of Ningxia Medical University

基　　金：国家自然科学资金(71463046);宁夏卫生厅与哈佛大学合作项目

摘　　要：目的了解宁夏海原县学龄前儿童卫生服务利用公平性变化趋势。方法采用多阶段分层随机抽样的方法,2009年基线调查随机抽取海原县7岁以下儿童进行卫生服务利用调查,并于2011、2012和2015年进行随访调查。结果被调查儿童2009、2011、2012和2015年两周就诊率依次为9.30%、9.55%、5.39%、7.33%,呈下降趋势(P<0.05);集中指数(CI)分别为0.034、0.058、0.019、0.074;2009、2015年不同经济组的就诊率差别均有统计学意义(P均<0.05)。四年患病未就诊率依次为28.42%、39.29%、55.25%、37.82%;CI分别为-0.007、-0.149、0.039、0.027;2011年不同经济组患病未就诊率差别有统计学意义(P<0.05)。四年住院率依次为8.38%、6.32%、7.23%、5.35%;CI分别为0.004、0.373、0.075、0.087;四年不同经济组的住院率差别均有统计学意义(P<0.05)。四年预防接种建卡率分别为74.23%、93.93%、86.05%、83.44%,总体呈上升趋势(P<0.05);CI分别为0.004、0.004、-0.002、0.016;2015年不同经济组建卡率差异有统计学意义(P<0.05)。四年健康体检率分别为28.22%、32.23%、37.01%、21.25%;CI分别为0.061、0.03、0.046、0.13;三年随访不同经济组健康体检率差别均有统计学意义(P均<0.05)。结论海原县学龄前儿童卫生服务利用公平性四年间有不同程度的改善,但有待提高重点特殊人群的医疗保健现状。Objective To understand the variation tendency of health service utilization for preschool children in Haiyuan County of Ningxia Province,and to provide the data support for the follow-up policy.Method Using the method of multi-stage stratified random sampling,the children under 5 years old in Haiyuan County were randomly sampled in the baseline survey in 2009 for health service utilization survey,and the children under 7 years old were followed up in 2011,2012 and 2015.Results Two-week visiting rates of children under investigation during four years were 9.30%,9.55%,5.39%and 7.33%respectively with a downward trend(P<0.05).Corresponding CI(concentration index)were 0.034,0.058,0.019 and 0.074.There were significant differences in the rates of treatment among different economic groups in the year of 2009 and 2015.No consultation rates in the four years were 28.42%,39.29%,55.25%and 37.82%.Corresponding CI were-0.007,-0.149,0.039 and 0.027 respectively.There were significant differences in the rates of no consultation rates among different economic groups in 2011.Four-year hospitalization rates were 8.38%,6.32%,7.23%and 5.35%.Corresponding CI were 0.004,0.373,0.075 and 0.087 respectively.There were significant differences in the rates of hospitalization among different economic groups in the four years.During the four years,the rates of vaccination card establishment were respectively 74.23%,93.93%,86.05%and 83.44%,with a downward trend overall(P<0.05).Corresponding CI were 0.004,0.004,-0.002 and 0.016.There were significant differences in the rates of vaccination card establishment among different economic groups in 2015.Four-year physical examination rates were 28.22%,32.23%,37.01%and 21.25%.Corresponding CI were respectively 0.061,0.03,0.046 and 0.13.There were significant differences in the rates of physical examination among different economic groups during the three years of follow-up.Conclusion The fairness of health service utilization for preschool children in Haiyuan County of Ningxia Province was improved

关 键 词：学龄前儿童 农村 卫生服务利用 公平性 

分 类 号：R197.1[医药卫生—卫生事业管理]