流动人口基本公共卫生服务利用及影响因素分析

Status quo and determinants on basic public health services of floating population

目的：了解流动人口基本公共卫生服务利用情况及影响因素,为推进基本公共卫生服务均等化提供对策和建议.方法：利用2013年全国流动人口动态监测调查数据及2013年流动人口卫生计生基本公共服务专项调查数据,对流动人口基本公共卫生服务利用及影响因素进行分析.结果：流动人口基本公共卫生服务利用总体水平较低,最近一年内接受过体检的比例为33.02％,只有23.84％的流动人口在当地建立了居民健康档案,5.15％的流动人口了解有关职业病防治的法律法规,55.00％的流动人口没有接受过职业安全与健康防护培训.0～6岁儿童免疫接种和健康管理工作开展情况较好,但存在一定比例的重复建卡和重复管理情况.“不知道”和“没有时间”是其未接受各项基本公共卫生服务的主要原因;多因素分析显示,影响流动人口基本公共卫生服务利用的因素主要有：性别、年龄、教育程度、每天工作时间、流动范围及流入时间.结论：流动人口对基本公共卫生服务利用不足,健康意识薄弱和服务可及性差是影响该群体卫生服务利用的主要原因.应该提高该人群对基本公共卫生服务的认识,并探索适宜的服务机制,促进其对基本公共卫生服务的利用.

Objectives：To analyze the status and determinants on public health services of floating population and provide suggestions and strategies for promoting equality in basic public health services.Methods：Data from the 2013 National Dynamic Floating Population Monitoring Survey and 2013 Floating Population Public Health,Family Planning,Basic Public Services Survey were used to analyse the utilization and determinants on public health services of floating population.Results：For the floating population,the utilization of basic public health services is relatively lower; the proportion of the population receiving a health exam each year only reached 33.02％,while the proportion with a health record only reached 23.84％.Only 5.15％ of the population knew the laws and regulations for occupational disease prevention,while 55.00％ of them had not received any training on occupational safety and health protection.The work of immunization and health management for 0-6 year-old children has progressed smoothly,but there existed a certain percentage of duplicate health cards and duplicate management.Lack of knowledge and lack of time were the main reasons for unused services.A multifactor analysis indicated that gender,age,education,work time every day,scope of migration and inflow time were the main determinants impacting the utilization of public health services for the floating population.Conclusion：The utilization of public health services is inadequate for the floating population; poor health awareness and poor service accessibility were the main determinants behind the utilization of public health services.Awareness of public health services among the floating population must be urgently improved to develop an appropriate public health service mechanism so as to enhance the utilization of public health services among the floating population.