中国西部山区慢性病患者卫生服务利用现状及其影响因素分析——基于Anderson 模型的宁夏南部山区为例  

Current status and influencing factors of health services for patients with chronic diseases in western mountainous areas of China——Based on the Anderson model, taking the mountainous area of southern Ningxia as an example

作　　者：王文龙 虎昭言 高保锴 乔慧 WANG Wen-long;HU Zhao-yan;GAO Bao-kai;QIAO Hui(School of Public Health and Management,Ningxia Medical University,Yinchuan,Ningxia 750004,China)

机构地区：[1]宁夏医科大学公共卫生与管理学院,宁夏银川750004 [2]宁夏环境因素与慢性病控制重点实验室

出　　处：《现代预防医学》2022年第5期839-844,共6页Modern Preventive Medicine

基　　金：国家自然科学基金资助项目(71864030);宁夏高等学校一流学科建设(公共卫生与预防医学)资助项目(NXYLXK2017B08)。

摘　　要：目的了解中国西部山区慢性病患者卫生服务利用现状及其影响因素,为慢性病患者的卫生服务利用政策的制定提供参考依据。方法采取多阶段分层整群随机抽样方法,随机抽取调查2019年宁夏农村5县共6 531名慢性病患者和家庭的人口学特征及卫生服务利用情况,构建Anderson模型分析慢性病患者卫生服务利用的影响因素。结果宁夏南部山区五县慢性病患者两周内门诊就诊率为37.36%。多因素非条件logistic回归分析结果显示,年人均入5 000~10 000元、>10 000元、慢性病数量≥2种和自身健康评价好、一般、差的慢性病患者两周就诊率较高,年收入<5 000、患有一种慢性病和自身健康评价非常好的慢性病患者两周就诊率较低;需求因素对慢性病患者两周就诊率影响最大,使能资源因素对慢性病患者两周就诊率也有一定影响。结论宁夏南部山区慢性病患者两周就诊率较低,年人均收入、是否参加医疗保险、患慢性病种类数、自身健康评价状态是宁夏南部山区慢性病患者卫生服务利用的主要影响因素。Objective To understand the current situation and influencing factors of health service utilization for patients with chronic diseases in mountainous areas in western China, so as to provide a reference for the formulation of health service utilization policies for patients with chronic diseases. Methods A multi-stage stratified cluster random sampling method was adopted to randomly sample and investigate the demographic characteristics and health service utilization of 6 531 patients and families with chronic diseases in 5 rural counties in Ningxia autonomous region in 2019. An Anderson model was constructed to analyze the factors affecting the utilization of health services for patients with chronic diseases. Results In the five counties of southern Ningxia, the rate of outpatient visits for chronic disease patients within two weeks was 37.36%. The results of multivariate unconditional logistic regression analysis showed that, when the average annual income per capita was 5 000-1 000 yuan or >10 000 yuan, the number of chronic diseases was ≥2 types, and patients’ health evaluations were good, average or poor, the two-week consultation rate was higher. When the annual income was less than 5000, the patients had one chronic disease and their own health assessment was very good, the two-week consultation rate was lower. Demand factors had the greatest impact on the two-week consultation rate of patients with chronic diseases, and the enabling resource factor also had a certain impact on the two-week consultation rate of patients with chronic diseases. Conclusion The two-week consultation rate for patients with chronic diseases in the southern mountainous area of Ningxia autonomous region is relatively low. The annual per capita income, whether to participate in medical insurance, the number of chronic diseases, and their own health evaluation status are the main factors influencing their utilization of health services.

关 键 词：卫生服务利用 慢性病患者 影响因素 ANDERSON模型 

分 类 号：R197.1[医药卫生—卫生事业管理]