老年居民社区卫生服务的利用现状及影响因素

The Present Situation and Influencing Factors of Community Health Service for the Elderly Residents

目的:分析老年居民对社区卫生服务的利用情况及影响因素,为基层医疗机构更好地开展老年卫生服务提供依据。方法:选择贵阳市云岩区某社区为调查区域,采用分层随机抽样的方法,对509名60岁及以上老年居民进行问卷调查。结果:509名社区老年居民两周患病率为14.3%,慢性病患病率为54.2%,两周就诊率为12.4%;经济月收入低者患病率较高,差异有统计学意义(P<0.05);老年女性、初中及以上学历的老年居民慢性病患病率较高,差异有统计学意义(P<0.05);独居老年人、经济月收入低者就诊率较高,差异有统计学意义(P<0.05);门诊常见病诊治、慢性病防治、健康档案管理、家庭访视等社区老年卫生服务在文化程度高与经济收入高者中的利用度较低,差异有统计学意义(P<0.05);慢性病患者在慢性病防治、慢性病管理、用药指导和饮食指导中的利用度较高,差异有统计学意义(P<0.05)。结论:老年居民社区卫生服务项目的整体利用率不高,年龄偏大、文化程度高、无慢性病、医保报销属地都是影响社区老年居民卫生服务项目利用率的因素。

Objective：To discuss utilization and influencing factors of community health services for elderly residents and provide the basic for grassroots medical institutions to carry out community health services better.Methods：Stratified random sampling technique was adopted to conduct a question-naire survey in 509 elderly people.Results：Among 509 elderly people,two-week prevalence rate was 14.3%,the prevalence rate of chronic diseases was 54.2% and two-week visiting rate was 12.4%. The less monthly income,the higher the prevalence rate（P 〈0.05）.The elderly women and the eld-erly people with education of junior high school or above had higher rates of chronic diseases than other residents （P 〈0.05）.The solitary elderly people and the elderly people with lower income had higher rates of visiting a doctor within two weeks than others （P 〈0.05）.The community elderly health serv-ices including clinic diagnosis and treatment of common diseases,chronic disease prevention,health file management,and home visit were not frequently utilized in those elderly people who were highly-educated and in those elderly people with high income（P 〈0.05）.The prevention of chronic disea-ses,chronic disease management,medication and diet guidance were utilized frequently in those elder-ly patients with chronic diseases （P 〈0.05）.Conclusion：As a whole,the community elderly health services are not fully utilized in elderly residents,and influencing factors include education,medicare reimbursement dependency,etc.