四川农村空巢老人门诊服务利用现状及其影响因素分析  

Utilization and influencing factors of outpatient service among the empty in Sichuan rural areas

作　　者：许家鑫 程梓敉 刘永婧 张雪莉 潘惊萍 廖芳 黄娟 张菊英[1] XU Jia-xin;CHENG Zi-mi;LIU Yong-jing;ZHANG Xue-li;PAN Jing-ping;LIAO Fang;HUANG Juan;ZHANG Ju-ying(West China School of Public Health and West China Fourth Hospital^Sichuan University,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院,四川成都610041 [2]四川省卫生和计划生育信息中心 [3]电子科技大学附属医院·四川省人民医院心身医学中心,四川省精神医学中心

出　　处：《现代预防医学》2021年第23期4290-4293,4355,共5页Modern Preventive Medicine

摘　　要：目的研究四川省农村空巢老人门诊服务利用现状及其影响因素,为进一步促进农村空巢老人健康公平性以及改善卫生资源配置提供依据。方法利用四川省第六次国家卫生服务调查,纳入2 186名农村空巢老人作为研究对象,分析其门诊服务利用现状,并采用多水平零膨胀Poisson回归进行影响因素分析。结果农村空巢老人慢性病患病率为66.2%,两周患病率为64.2%,两周就诊率为73.4%,两周就诊首诊机构主要为基层医疗机构(52.4%),两周患病未就诊率为23.4%,排名前三的原因为自己知道治疗方法、经济困难、自感病轻。多因素分析结果显示,吸烟(OR=0.294,95%CI:0.118~0.734)、主要经济来源类型(OR=0.478,95%CI:0.268~0.850)为空巢老人两周是否就诊的保护险因素,慢性病个数(OR=6.092,95%CI:3.074~12.074)为其危险因素;文化程度(OR=0.773,95%CI:0.624~0.957)为空巢老人两周就诊次数的保护因素,吸烟(OR=1.568,95%CI:1.259~1.953)、慢性病个数(OR=2.477,95%CI:1.835~3.343)为其危险因素。结论缺乏健康素养以及经济困难是限制农村空巢老人卫生服务利用的主要因素,不健康的行为生活方式以及慢性病增加了空巢老人的医疗负担。Objective To investigate the utilization and influencing factors of outpatient services among empty-nesters in rural areas of Sichuan Province, and to provide a basis for further promoting the health equity of rural empty nesters and improving the allocation of health resources. Methods Based on the Sixth National Health Service Survey in Sichuan Province, 2 186 rural empty nesters were involved as the research objects. Multilevel zero-inflated Poisson regression was performed to explore the influencing factors of outpatient services utilization. Results The prevalence rate of chronic diseases was 66.2% of empty-nesters in rural areas, the two-week prevalence rate was 64.2%, the two-week visiting rate was 73.4% and the main medical institutions were the primary medical institutions(52.4%). People without physician contact within two weeks were 23.4%. Among the reasons for not going to the hospital, knowing the treatment methods, economic difficulties and mild self-induced diseases ranked the top three. Multivariate analysis showed that Smoking(OR=0.294,95%CI: 0.118-0.734) and main source of income(OR=0.478,95%CI: 0.268-0.850) were the protective factors for empty nesters seeking medical treatment within two weeks. The number of chronic diseases(OR=6.092,95%CI: 3.074-12.074) was the risk factor. Education level(OR=0.773,95%CI: 0.624-0.957) was a protective factor for the number of visits in two weeks, while smoking(OR=1.568,95%CI: 1.259-1.953) and the number of chronic diseases(OR=2.477,95%CI: 1.835-3.343) were risk factors. The number of chronic diseases, main sources of income were the influencing factors of whether empty nesters see a doctor in two weeks. Education level, smoking, the number of chronic diseases were the influencing factors of the number of visits to the doctor in empty-nesters in two weeks. Conclusion Lack of health literacy and economic difficulties are the main factors limiting the utilization of health services for rural empty-nesters. Unhealthy behaviors and lifestyles and chronic diseases

关 键 词：农村空巢老人 门诊服务利用 多水平零膨胀Poisson回归 

分 类 号：R197.1[医药卫生—卫生事业管理]