四川省老年居民卫生服务需要与利用情况分析

Analyzing the status of elder residents'need and utilization of health services in Sichuan Province

目的:了解四川省60岁及以上老年居民的卫生服务需要与利用情况,以便有针对性地采取措施。方法:对四川省第四次卫生服务调查资料家庭数据库进行分析。结果:老年居民自评健康状况得分68.0分(城乡分别为70.0分、65.9分)。在行动、自我照顾、日常活动、疼痛/不适、焦虑/抑郁方面有中度以上健康问题的比例分别为16.3%、11.2%、16.1%、24.2%、14.9%,农村各项健康问题均高于城市。老年居民两周患病率为43.9%(城乡分别为43.8%、44.0%),慢性病患病率为56.9%(城乡分别为65.8%、47.4%)。在失能方面,4.7%的老年居民长期卧床;6.1%的老年居民很难听清楚;14.3%的老年居民说话有困难;29.5%的老年居民视力存在困难。老年居民的两周就诊率为41.1%(城乡分别为25.9%、57.2%),年住院率为19.3%(城乡分别为20.6%、18.0%),应住院而未住院率为18.5%(城乡分别为17.0%、20.3%)。两周患病未治疗的原因中,城市以自感病轻为主(63.9%),其次为经济困难(16.7%);农村经济困难则为首要原因(占49.2%),其次为自感病轻(38.9%);城乡应住院而未住院的首位原因均为经济困难(城乡分别为81.0%、85.5%)。结论:四川省老年居民卫生服务需要量较大,农村尤为明显。老年居民对卫生服务的利用情况较好。提高老年人的社会医疗保障,降低医药费用,可进一步促进老年居民对卫生服务的利用。

Objective To study the status of health services need and utilization of elder residents aged 60 and above in Sichuan Province,and obtain effective countermeasures.Methods Database from the fourth health services investigation in Sichuan Province was analyzed.Results The self-assessment score of health status of the elderly was 68.0,which was 70.0 in urban areas and 65.9 in rural areas respectively.The proportions of people with moderate unhealthy problems as action,self-care,daily activity,pain and anxiety were 16.3%,11.2%,16.1%,24.2%and 14.9%,respectively.The morbidity within two weeks among elderly was 43.9%,which was 43.8%in urban areas and 44.0%in rural areas respectively.And the prevalence rate of chronic disease was 56.9%,which was 65.8%in urban areas and 47.4%in rural areas respectively.As for disability,4.7%of them had to be lain in bed,6.1%,14.3%and 29.5%of them were difficult in hearing,speaking and vision,respectively.The rate of obtaining medical treatment was lower.The reasons of old people not being treated were regarding it as not serious（63.9%）and economic burden（16.7%）in urban areas,while they were economic burden（49.2%）and regarding it as not serious（38.9%）in rural areas.Conclusion The elderly in Sichuan Province had greater demand of health services,especially in rural areas.The status of utilizing health services was good.Social medical insurance on the elderly should be improved,and medical cost needs to be decreased to promote the utilization of health services.