山东省农村空巢老年高血压患者社会资本对门诊服务利用情况的影响  

Impact of Social Capital on Utilization of Outpatient Service Among Rural Empty-nesters with Hypertension in Shandong Province

作　　者：苏军 邵頔 刘保国 王佳敏 孙晓杰 SU Jun(Center for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,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 [3]江苏省扬州市卫生健康委员会,江苏扬州225002

出　　处：《医学与社会》2024年第10期33-41,共9页Medicine and Society

基　　金：国家自然科学基金资助项目,编号为31900785;山东省自然科学基金资助项目,编号为ZR2019MG013。

摘　　要：目的:探究山东省农村空巢老年高血压患者社会资本对门诊服务利用情况的影响,为提高农村空巢老年高血压患者卫生服务利用率提供参考依据。方法:采用多阶段分层随机抽样方法,于2021年6-7月在山东省抽取835名≥60岁的农村空巢老年高血压患者进行问卷调查。采用χ^(2)检验、点二列相关分析和两水平logit回归分析个体社会资本和村庄社会资本对门诊服务利用情况的影响。结果:山东省农村空巢老年高血压患者个体社会资本平均得分为(18.66±4.13)分,村庄社会资本中的村庄信任、村庄互惠和互助维度得分较高的患者分别占54.61%和53.89%。在控制混杂因素后,个体社会资本的专家咨询资源维度得分(OR=1.192,P=0.005)与患者门诊服务利用情况呈正相关;日常生活资源维度得分(OR=0.870,P=0.006)与患者门诊服务利用情况呈负相关。结论:山东省农村空巢老年高血压患者社会资本整体处于较高水平;个体社会资本中的专家咨询资源和日常生活资源维度对门诊服务利用情况分别具有正向和负向作用;医保类型、就医决策情况、自评健康状况等因素对门诊服务利用情况均有影响。Objective:To investigate the impact of social capital on the utilization of outpatient service among empty-nesters with hypertension in rural areas of Shandong province,so as to provide a reference for improving the utilization of health service among empty-nesters with hypertension in rural areas.Methods:Using multistage stratified random sampling,we conducted a questionnaire survey among 835 empty-nesters with hypertension in rural areas aged≥60 years in Shandong province during June to July 2021.Theχ^(2) test,point-two column correlation analysis and two-level logit regression were used to analyze the impact of individual social capital and village social capital on the utilization of outpatient service.Results:The mean individual social capital scores of empty-nesters with hypertension in rural areas in Shandong province were(18.66±4.13),and the percentages of patients with high village trust,and high village reciprocity and mutual aid of their village social capital were 54.61%and 53.89%,respectively.After controlling for confounders,expert consultation resources dimension scores(OR=1.192,P=0.005)were positively associated with the utilization of outpatient service,and daily life resources dimension scores(OR=0.870,P=0.006)were negatively associated with the utilization of outpatient service among their individual social capital.Conclusion:The overall social capital of empty-nesters with hypertension in rural areas of Shandong province is at a high level.The expert consultation resources and daily life resources of their individual social capital have positive and negative effect on promoting the utilization of outpatient service,respectively.The factors such as the type of medical insurance,decision-making about medical care and self-assessment of health status influence the utilization of outpatient services.

关 键 词：门诊服务利用 社会资本 高血压 空巢老人 农村 山东 

分 类 号：R-05[医药卫生] R195.4