徐州市流动老年人卫生服务利用及影响因素研究--基于安德森模型  

Study on health service utilization and influencing factors of floating elderly in Xuzhou city based on Anderson model

作　　者：李桂圆 王庆志 侯皓 漆子健 苗春霞 严文君 高修银 LI Gui-yuan;WANG Qing-zhi;HOU Hao;QI Zi-jian;MIAO Chun-xia;YAN Wen-jun;GAO Xiu-yin(School of Public Health,Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州医科大学公共卫生学院,江苏徐州221000 [2]武汉大学公共卫生学院 [3]徐州医科大学管理学院

出　　处：《现代预防医学》2024年第13期2422-2428,共7页Modern Preventive Medicine

基　　金：国家社会科学基金项目(19BGL251);江苏省卫生健康委基金项目(Z2019012);江苏省教学科学十四五规划重点课题(JS/2021/GH0106-07330)。

摘　　要：目的分析徐州市流动老年人的卫生服务利用现状及其影响因素,为促进健康老龄化提供参考。方法采用多阶段随机抽样的方法,选取徐州市城区60岁及以上流动老年人作为研究对象,构建安德森卫生服务利用行为模型,采用二元logistic回归分析探究流动老年人的门诊及住院卫生服务利用的影响因素。结果568名流动老年人中,73名(12.85%)最近两周接受过门诊服务,109人(19.19%)过去1年接受过住院服务。回归分析结果显示,大专及以上文化程度(OR=0.132,95%CI:0.025~0.706)、有养老保险(OR=4.338,95%CI:1.861~10.111)、到最近医疗机构时长超过60 min(OR=0.193,95%CI:0.047~0.797)、近两周患病(OR=14.911,95%CI:7.316~30.389)是流动老年人门诊服务利用的影响因素。年龄在80岁以上(OR=3.382,95%CI:1.231~9.294)、有养老保险(OR=2.064,95%CI:1.088~3.916)、有医疗保险(OR=2.883,95%CI:1.216~6.836)、自评健康状况一般(OR=0.355,95%CI:0.215~0.588)和好(OR=0.170,95%CI:0.096~0.301)、慢性病数量(1种:OR=5.412,95%CI:2.632~11.125;2种:OR=6.863,95%CI:3.189~14.769;3种及以上:OR=29.145,95%CI:12.418~68.401)是流动老年人住院服务利用的影响因素。结论徐州市流动老年人卫生服务利用情况总体不佳。相关卫生部门应聚焦流动老年人医疗保险覆盖情况,加强对距医疗机构较远、患多种慢性病、自评健康状况差的流动老年人的关注,重视流动老年人群社区健康教育与个性化健康教育的开展与干预,促进其提高健康意识、树立健康理念。Objective To analyze the current situation and influencing factors of health service utilization of the floating elderly in Xuzhou,so as to provide references for promoting healthy aging.Methods By using the method of multi-stage random sampling,the floating elderly aged 60 and above in Xuzhou city were included in this study,and the Anderson health service utilization behavior model was constructed.Binary Logistic regression analysis was used to explore the influencing factors of outpatient and inpatient health service utilization.Results Of the 568 floating elderly,73(12.85%)received outpatient services in the last two weeks,and 109(19.19%)received in-patient services in the past year.The results of regression analysis showed that college education(OR=0.132,95%CI:0.025-0.706),endowment insurance(OR=4.338,95%CI:1.861-10.111),the length of time to the recent medical institution exceeding 60min(OR=0.193,95%CI:0.047-0.797)and illness in the past two weeks(OR=14.911,95%CI:7.316-30.389)were the influencing factors of outpatient service utilization for the floating elderly.Over 80 years of age(OR=3.382,95%CI:1.231-9.294),endowment insurance(OR=2.064,95%CI:1.088-3.916),medical insurance(OR=2.883,95%CI:1.216-6.836),self-rated general health(OR=0.355,95%CI:0.215-0.588)and self-rated good health(OR=0.170,95%CI:0.096-0.301),and number of chronic diseases(one disease:OR=5.412,95%CI:2.632-11.125;two diseases:OR=6.863,95%CI:3.189-14.769;3 or more diseases:OR=29.145,95%CI:12.418-68.401)were the influencing factor of hospitalization service utilization for the floating elderly.Conclusion The utilization of health services among the floating elderly in Xuzhou was generally inadequate.Health authorities should prioritize expanding medical insurance coverage for this population,particularly those residing far from medical facilities,managing multiple chronic conditions,and reporting poor self-rated health.Furthermore,attention should be directed towards developing community health education and personalized health interventions ta

关 键 词：流动老年人 卫生服务利用 安德森模型 影响因素 

分 类 号：R193.2[医药卫生—卫生事业管理]