社区残疾人康复服务需求的影响因素研究

Study on the influencing factors of demand on rehabilitation services for the disabled in community

目的:了解我区社区残疾人康复服务的需求现状,探讨影响其接受康复服务的因素。方法:采用单纯随机抽样方法,选择我区450名残疾居民作为研究对象,由调查员上门对残疾人本人或/和监护人进行面访问卷调查,采用SPSS13.0对实验数据进行统计分析,单因素分析采用χ2检验,多因素分析采用多因素Logistic回归分析。结果:在所收回的433份调查问卷中男性231例,女性202例;选择公立医院进行康复服务占51.0%,选择社康中心康复占24.0%,选择在家的占14.8%,选择私立机构的占6.9%。总康复需求率为98.4%。其中医疗服务需求占52.0%,训练指导需求占41.3%,用品用具需求占32.8%,知识宣传需求占19.2%,心理辅导需求占15.0%,转介服务需求占9.7%。单因素分析显示,是否距离近就医方便、是否医生水平高、是否付费合理、是否公费医疗/基本医疗保险定点医疗单位、残疾年限、对康复服务的了解程度、对改善自身残疾状况的态度、是否相信接受康复服务能改善残疾及是否愿意接受康复服务等因素,在最近3个月内是否接受康复服务上的构成比的差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,收费合理、相信经过接受康复服务能改善残疾、对医疗费用的承受程度、残疾年限、对康复服务的了解程度及对改善自身残疾状况的态度对残疾居民接受康复服务影响较大。结论:公立医院和社康中心是提供康复服务的主要单位,应尽快加快适宜康复技术;针对影响社区残疾人接受康复服务的因素改善措施,使更多的残疾人享受康复服务。

Objective： To find out the real situation of the demand on rehabilitation services for the disabled in our community and discuss the issues and factors affecting their acceptance of rehabilitation services. Method ： The simple random sampling method was used to interview and make an investigation on the disabled themselves or their guardians of the selected 450 disabled residents of our region. The experimental data was statistically analyzed by using SPSS13.0. The result of analysis of single - factor was tested with X2 and multivariate Logistic regression analysis was used for multi - factor analysis. Results ： In the 433 collected questionnaires, there were 231 male cases and 202 female cases. The patients who took the choice of rehabilitation services in public hospitals accounted for 51.0%, in community health center accounted for 24.0%, at home accounted for 14. 8% and in private hospitals accounted for 6.9%. The total rate of rehabilitation need was 98.4%. Demand for medical services accounted for 52.0% , coaching need accounted for 41.3 %, demand for equipment accounted for 32.8 % , demand for popularization of related knowledge accounted for 19.2%, demand for psychological counseling accounted for 15.0% and demand for referral services accounted for 9.7%. Univariate analysis showed that there were statistically significant differences in such factors as convenience of proximity to medical service, high professional level of the doctors, reasonable cost, public health or basic medical insurance designated units, years of disabihty, level of understanding of rehabilitation services, attitude towards the improvement of their disability and their willingness to accept rehabilitation services, etc. （ P 〈 0.05）. Multivariate Logistic regression analysis showed that reasonable charges, confidence in the improvement of disability after receiving rehabilitation services, the capacity to bear the medical expenses, years of disability, level of understanding of rehabilitation services and the attitude towards the expectancy of the improvement made a greater influence on the acceptance of rehabilitation services for disabled residents. Conclusion： The public hospitals and community health centers are the main sectors to provide rehabilitation services and appropriate community -based rehabilitation techniques should be introduced as soon as possible, and the sectors should improve measures aiming at the factors to affect the acceptance of rehabilitation services so that more people with disabilities can enjoy rehabilitation services in community.