贵州省城乡老年人卫生服务需求与利用调查

An Investigation of Demand and Utilization of Health Services among the Elderly in Rural and Urban Areas of Guizhou Province

目的:调查贵州省城乡老年人卫生服务需求与利用情况,为老年人卫生服务在城乡的开展和健康发展提供依据。方法:采用多阶段分层整群随机抽样方法,对贵阳市城区和正安县的4535名老年人进行问卷调查;单因素分析采用t检验和χ2检验,多因素分析采用非条件Logistic回归。结果:城市和农村社区老年人的两周患病率分别为29.7%和64.7%,两周就诊率为9.5%和34.7%,慢性病患病率分别为62.1%和56.4%;城市老年人就诊地点主要以县市级和省级医院为主,两者所占比例为66.9%;农村则以个体诊所或村卫生室为主,占73.3%;两周患者未就诊原因在城市主要是自感病轻(占21.7%)和自我医疗(占51.6%),在农村主要为经济困难(占40.8%)和自感病轻(占25.9%);影响老年人两周就诊的因素在城市为年龄和家庭人均月收入,在农村是患慢性病与否。结论:我省城乡老年人卫生服务需要偏高,老年人的卫生服务均存在低利用的特点,农村低利用情况较城市更为严重。

Objective：To study the current status of demand and utilization of health services of rural area and urban community among the elderly in Guizhou in order to set a foundation to the development of health services of rural area and urban community.Methods：Using multistage cluster and random sampling technique,4535 old people were included in the survey and relevant data were collected with questionnaire.t and χ2 tests were adopted in single factor analysis,and un-conditional Logistic regression used in multivariate analysis.Results：The prevalence rates within two weeks among the elderly were 29.7% and 64.7%,and the rates of seeing a doctor within two weeks were 9.5% and 34.7% in urban community and rural areas respectively.The prevalence rates of chronic diseases were 62.1% and 56.4% in city and rural area respectively.Sixty-six point nine percent of the elderly in urban community went to high-level hospitals for medical services,while 73.3% of old people in rural area went to village clinics.The main reasons for diseased people not to visit a doctor were self feeling of slight illness（21.7%）and self-treatment（51.6%）in urban community and were low income（40.8%）and self feeling of slight illness（25.9%）in rural areas.The main affecting factors to rates of seeing a doctor within two weeks were increased age and family income per capita among the elderly in urban community,and were suffering or not suffering from chronic diseases in rural area.Conclusions：The elderly have a high demand to health services in Guizhou.However,the utilization of health services among the elderly is low,especially in rural area.