中国0～17岁人口两周患病服务利用状况分析

Analysis on factors affecting utilization of health services for patients 0～17 years old in China

[目的]研究我国0--17岁人口两周患病就诊与治疗的影响因素，为提高0～17岁人口卫生服务利用提供依据。[方法]利用3次国家卫生服务调查资料，计算1993--2003年0--17岁人口两周患病未就诊率和未治疗率，分析变化趋势，并进行相关因素分析。[结果]1993--2003年0～17岁人口的两周患病未就诊率增高，未治疗率有所下降；影响城市与农村服务利用的因素不同，城市自感疾病严重程度轻、所患疾病为慢性病持续到两周内、患者年龄大者未就诊或未治疗比例较高，农村除与城市相同的影响因素外，家庭经济状况和离最近医疗点距离也是主要影响因素。[结论]影响城市0--17岁人口诊治的主要因素是病情，可采用健康教育等社会干预方式提高卫生服务利用；而农村地区的影响因素包括经济状况，说明农村地区就医贵、就医难对未成年人健康造成了不利影响，需采取制定特殊医疗政策等政府干预方式，提高农村贫困人口的卫生服务利用。

[Objective] To find factors affecting health service utilization of two-week illness in 0-17 years old people in China, and to provide policy evidence on improving health service utilization. [Methods] The data of the National Health Services Survey of China was used to calculate the proportion of visiting doctors and treatment of two-week illness from 1993 to 2003. [Results] Proportion of non-visiting doctors was higher in 2003 than in 1993, while proportion of non-treatment was lower in 2003. Factors affecting urban and rural patients were different. Severity of illness, starting time of disease and age of patients were factors relating to urban health utilization. Besides, family economic status and dis- tance to nearest health facility were factors relating to rural health utilization. [Conclusion] The most important affecting factor is severity of illness in urban areas, and that health education could be used to improve health utilization. In rural areas, expenditure and expedience for treatment are main factors obstructing health utilization of young people. Special health policy should be made for rural patients, especially for those in poverty.