基于EQ-5D-3L的宁夏回族自治区农村居民健康相关生命质量与卫生服务利用的关系研究  

Health-related Quality of Life Measured Using the EQ-5D-3L and Health Service Utilization in Rural Residents of Ningxia

作　　者：李培雯 贺嘉慧 马喜民 乔慧 LI Peiwen;HE Jiahui;MA Ximin;QIAO Hui(School of Public Health and Management,Ningxia Medical University,Yinchuan 750004,China;Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control,Yinchuan 750004,China)

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

出　　处：《中国全科医学》2023年第19期2361-2368,共8页Chinese General Practice

基　　金：国家自然科学基金资助项目(71864030,72164033)。

摘　　要：背景探讨影响卫生服务利用的因素对于优化卫生服务资源配置具有重要作用。健康相关生命质量(HRQoL)作为主观评价指标,能够在一定程度上体现居民对自身健康状况的判断并影响其求医行为。目前,国内关于HRQoL对农村居民卫生服务利用影响的研究较少。目的探索HRQoL与宁夏回族自治区农村居民卫生服务利用的关系,为政策/计划的制定、农村卫生服务的优化提供参考与依据。方法于2019年7—8月,采用宁夏回族自治区4个样本县(海原、彭阳、西吉、盐池县)“农村居民家庭卫生健康询问调查”2019年数据,选取年龄≥15周岁且重要信息(如性别、年龄、HRQoL指标、卫生服务利用指标等)完整的9310例居民作为研究对象,采集调查对象社会经济学与人口学特征、卫生服务可及性、慢性病患病情况、HRQoL、卫生服务利用情况五方面的资料,基于欧洲五维三水平健康量表(EQ-5D-3L)测量调查对象HRQoL,采用二分类Logistic回归分析调查对象健康效用值及直观式测量表(VAS)评分对其门诊、住院卫生服务利用的影响。结果宁夏回族自治区农村居民的门诊卫生服务利用率为10.85%(1010/9310),住院卫生服务利用率为18.86%(1756/9310);健康效用值的均值为(0.965±0.090),VAS评分的均值为(69.97±17.84)分。差异性检验结果表明,在欧洲五维健康量表(EQ-5D)健康描述系统自我照顾能力维度上存在问题者与在其他维度上存在问题者相比,利用门诊卫生服务、住院卫生服务的可能性更高[OR(95%CI)分别为3.197(2.633,3.883)、4.802(4.059,5.681),P<0.001]。二分类Logistic回归分析结果显示,矫正各项混杂因素后,健康效用值和VAS评分均是影响宁夏回族自治区农村居民门诊、住院卫生服务利用情况的影响因素(P<0.05)。此外,是否患有慢性病亦对农村居民门诊、住院卫生服务利用情况有明显影响(P<0.05)。结论HRQoL和慢性病患病情况是�Background Exploring the factors affecting health service utilization is of great significance for optimizing the allocation of health services.Health-related quality of life(HRQoL)focuses on individuals' subjective self-assessment of their current health status,and may affect their health-seeking behaviors,but there are few studies on the impact of HRQoL on health service utilization of rural residents in China.Objective To explore the relationship between HRQoL and health service utilization of rural residents in Ningxia Hui Autonomous Region,and to provide a reference for the development of relevant policies/plans,and for the optimization health services in rural areas.Methods Data were collected from the Health Survey of Rural Residents Families 2019 conducted in four sample counties of Ningxia(Haiyuan,Pengyang,Xiji,Yanchi)from July to August 2019,involving 9 310 cases(≥ 15 years)with complete key information(gender,age,HRQoL-related indicators,health service utilization indicators).Detailed data of the residents were extracted,including socio-economic and demographic characteristics,health services accessibility,prevalence of chronic diseases,HRQoL measured using European Quality of Life 5 Dimensions 3 Level Version(EQ-5D-3L)and utilization of health services.The effects of health state utility values and visual analog scale(VAS)score on outpatient and inpatient health service utilization were analyzed by binary Logistic regression.Results The utilization rates of outpatient and inpatient health services of rural residents in Ningxia were 10.85%(1 010/9 310)and 18.86%(1 756/9 310),respectively.The mean health state utility values and mean VAS score of them were(0.965±0.090)and(69.97±17.84),respectively.Difference testing showed that residents with impaired self-care(in the EQ-5D-3L descriptive system)had higher rates of using outpatient health services[OR(95%CI)=3.197(2.633,3.883),P<0.001]and inpatient health services[OR(95%CI)=4.802(4.059,5.681),P<0.001]compared with those with impaired mobility,usual a

关 键 词：健康相关生活质量 卫生服务利用 卫生保健质量 获取和评价 农村居民 欧洲五维三水平健康量表 健康公平 宁夏[回族自治区] 

分 类 号：R163[医药卫生—公共卫生与预防医学] R195