1991—2011年中国预防医学服务利用趋势及公平性分析

Utilization and equity of preventive care in China from 1991 to 2011

目的:分析1991—2011年间中国居民预防医学服务利用的影响因素、趋势以及公平性。方法:利用中国健康和营养调查(China Health and Nutrition Survey)数据,通过多元logistic回归分析探讨预防服务利用的影响因素;对预防服务利用率随时间变化进行趋势检验;最后借助集中指数进行公平性分析。结果:总预防服务和一般健康检查的利用率随时间逐渐增加,且具有统计学意义。高血压筛查和妇科检查不公平性不再显著,但一般健康检查和查血服务仍然倾向于高收入群体。人均收入、性别、教育程度、医疗保险类型等是影响预防服务利用的主要因素。结论:预防服务利用率显著提升。预防服务利用公平性有所改善,但是不公平性仍然存在,尤其体现在一般健康检查和查血方面。

Objective： To analyze the influential factors,trend and equity of preventive care utilization in China from 1991 to 2011. Methods： Using China Health and Nutrition Survey（ CHNS）,logistic regression was applied to explore influential factors,study time trend of preventive care utilization,and examine its equity by Concentration Index. Results： Total preventive care services and physical examination utilization significantly increased. Significant inequity still exit in terms of general physical examination and blood text,however,disappeared with respect to blood pressure screening and gynecological examination. Main influential factors of preventive care utilization includes income,gender,education and insurance,etc. Conclusion： Preventive care utilization had significantly grown with decreasing inequalities,but inequity still exit,particularly for general physical examination and blood test.