新疆游牧和定居牧民卫生服务需求利用调查

Demand,utilization of health service among herders and residents in pastoral areas of Xinjiang

目的了解新疆牧区游牧和定居牧业居民(简称牧民)卫生服务需求利用的现状,为新疆牧业医院人力配置规划及能力建设目标提供决策依据。方法采用分层整群抽样方法,对新疆新源县、沙湾县和阿勒泰市3个牧业县1 055户游牧和665户定居牧业居民进行家庭健康询问调查。结果2008年新疆牧区被调查牧民2周就诊率为6.8%,2周未就诊率为53.6%;住院率为5.1%,未住院率为27.8%;牧民2周就诊和住院率低于同期全国农村水平,2周患病未就诊和未住院率高于同期全国农村水平;游牧和定居牧民2周就诊率和未住院率差异无统计学意义;游牧牧民2周患病未就诊率(55.8%)高于定居牧民(48.2%),住院率(4.4%)低于定居牧民(6.5%);游牧牧民就诊选择牧业点设立的医疗机构比例和住院利用乡镇卫生院比例均高于定居牧民;就医可及性差是牧区居民卫生服务利用不足的主要原因。结论目前提供的卫生服务尚不能满足居民的卫生服务需求,同时卫生服务利用不足,游牧牧民比定居牧民更严重,应加强牧区基层卫生服务体系建设。

Objective To describe health service demand and utilization among herders and residents in the pastoral areas of Xinjiang for the planning and capacity-building of hospital in Xinjiang.Methods A total of 1055 nomadic families and 665 resident families in three animal husbandry counties in Xinjiang were randomly chosen with stratified-cluster sampling method for the family health survey.Results Among the participants,the two-week consultation rate was 6.8%.Among the participants with illness,the two-week non-consultaiton rate was 53.6%;the hospitalization rate was 5.1% and non-hospitalization rate was 27.8% in 2008.The two-week medical consultation and hospitalization rate of herdsmen were well below the national level for rural area in 2008 and the two-week non-consultation rate and non-hospitalization rate were higher than the national level for rural area.The difference of two-week medical consultation rate and non-hospitalization rate between nomadic and resident herder were not statistically different.The two-week non-consultation rate for nomadic herders（55.8%） was higher than that of resident herders（48.2%）,but hospitalization rate for nomadic herdsmen（4.4%） was lower than that of resident herders（6.5%）.The proportions of selecting medical institution in animal husbandry point and using township hospitals for hospitalization were higher among the nomadic than among the residents of herdsmen.Conclusion The health status of herdsmen in Xinjiang was poor,and the provision of health services cannot meet the demand for health service.Utilization of health service is insufficient and health service system of the grassroots in pastoral areas should be strengthened.