北京市农村地区老年人健康管理服务现状研究

Application of health management programme among elderly adults living in rural areas of Beijing

目的 了解北京市农村老年人健康管理现状,为提高老年人健康管理服务质量提供参考.方法 2013年采用多阶段随机抽样选取北京市大兴等8个郊区县部分农村60岁及以上老年人为研究对象,了解其接受健康管理服务的现状及满意度状况,并对不同地区间的服务现状进行描述和比较.结果 调查对象过去1年参与健康体检工作的总体比例为71.3％（719/1 023）,参与心理压力管理仅为0.4％（4/1 023）;参与慢性病随访的比例为4.9％（35/710）,参与健康体检、健康档案建立、健康教育、健康咨询、健康状况评估、肿瘤筛查、疫苗接种等活动比例在地区分布上差异有统计学意义（x2=15.7、39.4、30.5、25.2、24.1、18.4、19.3,均P＜0.05）;参与健康体检、健康档案建立、健康教育等活动场所在地区分布上差异有统计学意义（均P＜0.05）;健康管理满意度影响因素分析发现,影响调查对象满意度的因素有年龄、职业因素、参加新农合保险、主观健康状况和参与健康档案建立情况等因素.结论 北京农村老年人健康管理的实施现状距国家公共卫生服务均等化要求尚有差距,且存在地区差异,老年居民对健康管理活动的满意度还有待进一步提高.

Objective To learn current status of health management services in the elderly individuals living in rural areas of Beijing, so as to provide evidence for heahhcare improvement. Methods The elderly residents aged 60 or above from several rural districts of Beijing were selected by using multi- stage random sampling method in January 2013. The health management programme those participants obtained and their satisfactory scale were evaluated. Results A total of 719 of 1 023 （71.3%） individuals had health check-up over the past years. Only 4 subjects （0.4%） obtained mental health management, and 35 （4.9%） finished follow-up studies for chronic diseases. The percent of the elderly who received physical examination, profiles of medical record, health education, medical consuhation, health evaluation, cancer screening or vaccination showed statistically significant difference of regional distribution （X2 values were 15.7, 39.4, 30.5, 25.2, 24.1, 18.4 and 19.3, respectively; all P〈0.05）. Sites for health check-up, profiles of medical record and health education were also found to have statistically significant regional distribution difference （all P〈O.05）. In ordinal logistic regression analysis, age, occupation, health insurance, self health assessment and health medical affected satisfaction of the respondents with health management. Conclusions Our investigation shows a gap between current health management programme and national standard requirement for equal public health services, and the elderly＇s satisfaction with health management needs to be improved.