中国儿童健康状况及服务利用地区差异分析

Regional differences in child health and service utilization in China

目的了解我国不同地区儿童健康状况及卫生服务利用的地区差异,为确定我国儿童保健工作重点及制定相应措施提供依据。方法以2008年中国卫生服务调查研究资料为基础,采用差异指数和地理分布图方法,分析儿童2周腹泻发病率、2周患病率、2周就诊率和住院率4项指标在不同地区的差异。结果儿童健康状况及卫生服务利用的4项统计指标均呈现农村高于城市。按照行政区域划分,儿童2周腹泻发病率较高的是西南(8.5%)和东北(8.0%),最低的是中南(5.1%);2周患病率和2周就诊率最高的都是中南(14.1%和20.9%),最低的均为西北(7.2%和6.9%);住院率最高的是中南(4.6%),最低的是华北(3.1%)。差异指数无论是在行政区域内部还是在全国范围基本都大于0.20,说明地区差异较为显著。结论我国儿童健康状况及卫生服务利用存在较大地区差异。

Objective To analyze regional differences of child health status and health service utilization in China, and to provide evidence for determinating the key to children＇s health care and making related countermeasures. Methods The index of difference （ ID} and distribution map were used in analyzing regional disparities in terms of two health status indicators, i. e. , perceived sickness （ PS ） and diarrhea incidence （ DI ） in the past two weeks and two service utilization indicators, i. e. , out-patient service using （ OSU ） in the past two weeks and inpatient services using （ ISU ） in the past year, based on data from China 2008 National Health Services Survey. Results All the four indicators were found to be lower in urban than in rural areas. By geographic regions, DI was the highest in the Southwest （8.5%） but the lowest in the Central and South China （5.1%）. PS and OSU were both found to be the highest in Central and South China （ being 14.1% and 20.9% respectively） and the lowest, in the Northwest （ 6.9% and 7.2% ）. The highest ISU （4.6%） was observed in Central and South China; yet the lowest ISU （ 3.1% ） , in North China. IDs of all the 4 indicators were larger than 0.20. Conclusion In China, there exist substantial regional disparities in child health status and health service utilization.