宁夏农村学龄儿童卫生服务利用公平性的动态研究  

A dynamic study on the equity of health service utilization for school-age children in rural areas of Ningxia

作　　者：刘刚军 马丽 乔慧 LIU Gang-jun;MA Li;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,宁夏银川750004

出　　处：《现代预防医学》2022年第24期4442-4445,4461,共5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学科)资助项目(NXYLXK2017B08)。

摘　　要：目的这项研究在于掌握宁夏农村地区学龄儿童卫生服务利用现状及卫生服务利用公平性的动态变化,为政府部门了解学龄儿童卫生服务利用情况提供数据支撑,为学龄儿童健康促进方案的科学发展提供基础依据。方法利用“农村居民家庭卫生健康询问调查”2009年开始的基准数据,以及2011、2012、2015和2019年随访调查数据,最终选取年龄为7~12岁并且调查时在家常住(指在家居住时间≥0.5年)的学龄儿童作为本次研究对象。利用χ^(2)检验对不同收入水平组间的率进行比较,使用集中指数(concentration index,CI)衡量不同收入水平群体间卫生服务利用公平性的变化。结果两周就诊情况经趋势χ^(2)检验显示不同调查年份之间差异有统计学意义(χ^(2)=16.189,P=0.004);χ^(2)检验显示,不同收入水平的人群在2011年(χ^(2)=13.416,P=0.028)、2012年(χ^(2)=22.489,P=0.009)存在统计上的显著差异。其他四年CI均为正值,只有2011年CI为负值,但是比较五次调查CI的绝对值,可以发现其保持下降。两周患病未就诊情况经趋势χ^(2)检验显示不同调查年份之间差异有统计学意义(χ^(2)=4.905,P=0.027)。CI值均为负值,并且绝对值表现为下降态势,不公平程度正在减弱。住院情况经趋势χ^(2)检验显示不同调查年份之间差异没有统计学意义(χ^(2)=0.047,P=0.829)。CI值均为正值,说明卫生服务利用偏向于高收入人群,绝对值整体上是下降的,表现为齿状波动样。结论在农村学龄儿童中,卫生服务利用水平较低,五次调查发现不公平程度正在逐渐减小。Objective To grasp the current situation of school-age childrens’health service utilization in countryside of Ningxia and the dynamic changes in the equity of health service utilization,to provide data support for government departments to understand the utilization of school-age childrens’health services,and provide a basis for the scientific development of school-age childrens’health promotion programs.Methods Based on the baseline data of“Inquiry Survey on Family Health of Rural Resident”in 2009 and the follow-up survey data in 2011,2012,2015,and 2019,the school-age children aged 7 to 12 years who lived at home at the time of investigation(i.e.staying at home for≥0.5 years)were selected as the research objects.Theχ^(2)test was used to compare the rates among groups with different income levels,and concentration index was used to measure the change of health service utilization equity among groups with different income levels.Results The trendχ^(2)test showed that there was a statistically significant difference between the different survey years in the two-week visits(χ^(2)=16.189,P=0.004).Theχ^(2)test showed that there were statistically significant differences between groups of different income levels in 2011(χ^(2)=13.416,P=0.028)and 2012(χ^(2)=22.489,P=0.009).The confidence interval(CI)of the other four years was positive,only the CI in 2011 was negative,but comparing the absolute value of CI in five surveys,there was a downward trend.The trendχ^(2)test showed that there was a statistically significant difference between the different survey years in patients who did not visit a doctor in two weeks of illness(χ^(2)=4.905,P=0.027).The CI values were all negative,the absolute value showed a downward trend,and the degree of unfairness was weakening.The trendχ^(2)test of hospitalization showed that there was no significant difference between different survey years(χ^(2)=0.047,P=0.829).The CI values of hospitalization rates were all positive,indicating that the utilization of health service

关 键 词：卫生服务利用公平性 农村学龄儿童 集中指数 

分 类 号：R197.1[医药卫生—卫生事业管理]