多维邻近性对流动人口慢性病患者慢性病防治教育利用的影响研究  

Study on the Impact of Multidimensional Proximities on the Utilization of Chronic Disease Prevention and Treatment Education among Migrant People with Chronic Diseases

作　　者：刘沼悦 刘俊萍 刘欣儒 王楠 吴琳 冯亚杰 张环宇 梁立波[1] Liu Zhaoyue(School of Health Management,Harbin Medical University,Harbin,P.R.China)

机构地区：[1]哈尔滨医科大学卫生管理学院,黑龙江哈尔滨150081

出　　处：《中国卫生事业管理》2025年第1期84-89,共6页Chinese Health Service Management

基　　金：国家自然科学基金项目“结核病防控资源多元剥夺对防控效果的跨层次影响机制及应对策略:公共卫生安全事件冲击视角的研究”(72274047);黑龙江省高校智库开放课题重点项目“高校结核病防控现状、问题及提升策略研究”(ZKKF2022087)。

摘　　要：目的:探析多维邻近性对流动人口慢性病患者慢性病防治教育利用的影响,为提高流动人口慢性病患者慢性病防治教育利用率,提升流动人口慢性病患者健康水平提供参考。方法:基于2017年全国流动人口动态监测调查A卷监测数据中的9272名流动人口慢性病患者资料,运用χ^(2)检验及二元Logistic回归进行分析。结果:流动人口慢性病患者慢性病防治教育利用率为38.35%,中部、西部地区慢性病防治教育利用率高于东部和东北地区,糖尿病与高血压和糖尿病共患病患者慢性病防治教育利用率高于高血压患者。逻辑回归结果显示,地理邻近性程度高(居住地到最近医疗服务机构时间在15分钟以内)(OR=1.131,95%CI:1.006~1.271)、组织邻近性程度高(在流入地参加组织或社会活动)(OR=1.883,95%CI:1.711~2.072)、非正式制度邻近性程度高(流入地与户籍地属于同一方言区)(OR=1.225,95%CI:1.093~1.373)和社会邻近性程度高(在流入地参与社会保障与保险和建立健康档案)(OR=1.186,95%CI:1.059~1.328;OR=4.181,95%CI:3.794~4.607)的流动人口慢性病患者利用慢性病防治教育可能性更高。结论:流动人口慢性病患者慢性病防治教育利用率较低且不同地区、不同慢病类型间差异较大。地理邻近性、组织邻近性、非正式制度邻近性与社会邻近性对流动人口慢性病患者慢性病防治教育利用均具有显著正向性影响。应关注户籍地与迁入地的差异性对流动人口基本公共卫生服务利用的影响,针对多角度问题采取多维举措,以推进基本公共卫生服务均等化。Objective To explore the impact of multidimensional proximities on the utilization of chronic disease prevention and treatment education among migrant people with chronic diseases,and provide a reference for improving the utilization rate of chronic disease prevention and treatment education among migrant people with chronic diseases and improving their health level.Methods Data of 9272 migrant people with chronic diseases in Volume A of the 2017 National Floating Population Dynamic Monitoring Survey were analyzed by using chi-square test and binary Logistic regression.Results The utilization rate of chronic disease prevention and treatment education among migrant people with chronic diseases was 38.35%,in which the utilization rates in the central and western regions were higher than those in the eastern and northeast regions,and the utilization rates in the patients with diabetes or hypertension and comorbid diabetes was higher than those in hypertension patients.The results of logistic regression showed that the migrant people with chronic diseases who had higher degree of geographical proximity(the nearest medical service within 15 minutes)(OR=1.131,95%CI:1.006~1.271),higher degree of organizational proximity(participating in organizational or social activities in the inflow place)(OR=1.883,95%CI:1.711~2.072),higher degree of informal system proximity(the area of common dialect)(OR=1.225,95%CI:1.093~1.373),and higher degree of social proximity(establishing social security and insurance in the inflow place,OR=1.186,95%CI:1.059~1.328,and establishing health records in the inflow place,OR=4.181,95%CI:3.799~4.607)were more likely to utilize the chronic disease prevention and treatment education.Conclusion The utilization rate of chronic disease prevention and treatment education among migrant people with chronic diseases was low,which varied in different areas and chronic diseases types.Geographical proximity,organizational proximity,informal system proximity and social proximity would have a significantly positi

关 键 词：多维邻近性 流动人口 慢性病防治教育 

分 类 号：R193[医药卫生—卫生事业管理]