山东省家庭医生签约服务与农村老年人健康体检的相关性研究  

Correlation between contracted family doctor services and physical examination of older adults in rural Shandong,China

作　　者：闫琛 赵丹[1,2] 李杰 李智贤[1,2] 杨士鋆 厉文娟[1,2] 桂珍 周成超 YAN Chen;ZHAO Dan;LI Jie;LI Zhixian;YANG Shijun;LI Wenjuan;GUI Zhen;ZHOU Chengchao(Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan,Shandong 250012,China;NHC Key Lab of Health Economics and Policy Research(Shandong University),Jinan,Shandong 250012,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,山东济南250012 [2]国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),山东济南250012

出　　处：《中国农村卫生事业管理》2022年第2期93-99,共7页Chinese Rural Health Service Administration

基　　金：国家自然科学基金项目(71774104、71974117、71473152);山东大学人文社科青年团队项目(IFYT1810)。

摘　　要：目的 分析山东省农村老年人健康体检利用现状,探索家庭医生签约服务与健康体检利用的相关性。方法 以山东省的地理位置和经济水平为依据,于2018年采用多阶段分层随机抽样法,抽取3个样本市作为研究地区,采用随机数字表抽取各个村的居民进行问卷调查,该研究共纳入其中的65岁及以上老年人984名。统计分析采用t检验、χ;检验、二元logistic回归等方法,探讨家庭医生签约服务与老年人利用健康体检的相关性。结果 984例老年人中,健康体检利用率为88.92%。家庭医生签约服务与山东省农村老年人利用健康体检呈正相关(OR=2.287, 95%CI:1.257~4.161,P<0.01)。高龄(OR=1.166, 95%CI:1.109~1.226,P<0.001)、高EQ-5D健康指数(OR=3.565, 95%CI:1.042~12.200,P<0.05)、多重慢病(OR=3.577, 95%CI:1.728~7.402,P=0.001)和参加体育活动(OR=1.637, 95%CI:1.052~2.547,P<0.05)的老年人健康体检利用情况较好。结论 山东省农村老年人健康体检利用率尚可,但仍有进一步提升空间,家庭医生签约服务是其相关因素之一。应针对未进行健康体检的老年人开展个性化健康指导工作,并深入普及家庭医生签约服务,加强健康宣教,尤其是要重视那些低龄、EQ-5D健康指数较低、无多重慢病、无体育活动习惯的老年人。Objective To investigate the status quo of older adults’ utilization of physical examination in rural Shandong, China and to explore the correlation between contracted family doctor services and physical examination of older people. Methods In 2018, a multi-stage stratified sampling method was adopted to randomly select three sample cities in Shandong province as the study sites based on geographic location and economic level, and residents of each village were selected by random number table for questionnaire survey. A total of 984 senior citizens aged 65 and above were included in this study. T test, Chi-square test, binary Logistic regression and other methods were used for statistical analysis to explore the correlation between contracted family doctor services and older adults’ utilization of physical examination. Results Among 984 senior citizens, 88.92% had physical examination. There was a positve correlation between contracted family doctor services and older adults’ utilization of physical examination in Shandong province(OR=2.287, 95% CI: 1.257~4.161, P<0.01). Residents with advanced age(OR=1.166, 95% CI: 1.109~1.226,P<0.001), high EQ-5 D health index(OR=3.565, 95% CI: 1.042~12.200, P<0.05), multiple chronic diseases(OR=3.577, 95% CI: 1.728~7.402, P=0.001), and participation in physical activities(OR=1.637, 95% CI: 1.052~2.547, P<0.05) had better utilization of physical examination. Conclusions In rural Shandong province, the utilization rate of physical examination for senior citizens was reasonable, but there were still room for further improvement, and contracted family doctor service was one of its relevant factors. Individualized health guidance need to be provided to the older adults who have not had physical examination, and contracted family doctor services should be further popularized. Meanwhile, health education need to be strengthened, especially for younger senior citizens and older adults who have low EQ-5 D health index, no multiple chronic diseases, and no habit of physical activi

关 键 词：老年人 健康体检 健康管理 家庭医生签约服务 相关因素 

分 类 号：R197[医药卫生—卫生事业管理] R161.7[医药卫生—公共卫生与预防医学]