北京市2013年流动人口自报患病及就诊行为分析

Self-reported morbidity and service utilization among migrant population in Beijing

目的分析北京市流动人口自报患病情况及就诊行为特点。方法利用国家卫生计生委2013年流动人口动态监测数据中的北京市数据,该数据采用PPS抽样方法抽取了北京市各区县流动人口总计8 000人,利用《流动人口动态监测调查问卷(A)(2013年)》,采取自填与访谈相结合的方式进行调查。结果调查对象自报2周患病率为2.5%,近一年曾患病的比例为9.4%,近一年内患病的人群中未就诊的比例为37.1%。对近一年患病后就诊选择的logistic分析发现,女性、年龄增加、在婚状态更有可能选择就诊;受教育程度在初中及以下的人群是大专及以上的人群未就诊风险比的2倍(95%CI 1.10-3.61);拥有本地医保的人群未就诊比是无本地医保人群的约2/3(OR=0.67,95%CI0.45-0.99)。结论北京市流动人口自报患病率相对较低,但患病后未就诊比例较高,是否拥有本地医保是影响患病就诊的重要因素之一,需要继续努力扩大流动人口医疗保障的覆盖水平,促进流动人口健康。

Objective To explore the self-reported morbidity and service utilization among migrant population in Beijing. Methods Data were from National Surveillance Data of Migrant Population 2013 （Beijing）. PPS sampling methods were used and 8000 migrant people were enrolled. Participants were surveyed by National Migrants Surveillance Questionnaire （A） （2013） which were completed by themselves or being interviewed. Results Self-reported two-week prevalence rate among migrants was 2.5% and one-year prevalence rate was 9.4%. The percentage of not seeking for health services among them was 37.1%. Logistic analysis was adopted to explore the influential factors of non-utilization of health services. It was showed that female, older, staying with couples were inclined to use health services once feeling uncomfortable. Those with educational level lower than middle school were two times more likely to decline visiting doctors than those with higher than college level （95% CI 1.10 - 3.61 ）. The ratio of non-utilization of health services among migrants with local health insurance is about 2/3 of that among migrants without it （ OR = O. 67,95% CI O. 45 - O. 99 ）. Conclusion The self-reported morbidity was relative lower among migrants in Beijing, but the non-utilization of health services was high. One of important impact factors was local health insurance coverage which implied that coverage of health insurance in migrants should be expanded gradually to promote migrants＇ health.