珠三角流动人口基本公共卫生服务利用及影响因素分析

Analysis of basic public health services utilization and influence factors of the floating population in the Pearl River Delta

目的了解流动人口基本公共卫生服务利用现状及影响因素,为进一步推动流动人口基本公共卫生服务工作的有序开展提供参考依据。方法采用非随机配额抽样方法,对2 736名流动人口基本公共卫生服务利用调查资料采用单因素和多因素非条件Logistic回归分析。结果流动人口基本公共卫生服务利用率30.37%显著低于户籍人口利用率43.23%（χ^2=98.05,P〈0.001）。单因素分析发现,婚姻、文化程度、收入、医保、对社区印象、听说过基本公共卫生服务、健康知识掌握程度、服务需求、接受服务意愿与基本公共卫生服务利用有关;多因素分析显示,听说过基本公共卫生服务项目（OR=3.98）、需要基本公共卫生服务（OR=2.34）、有医疗保险（OR=2.17）、对社区卫生服务中心印象好（OR=1.64）、愿意配合社区服务中心接受免费基本公共卫生服务项目（OR=1.62）、收入高（OR=1.37）是主要影响因素。结论流动人口基本公共卫生服务利用水平较低,医保制度的不完善和宣传不到位起重要作用。

Objective To understand the current situation and influencing factors of public health service utilization of floating population and provide reference for further promotion of the orderly development of the basic public health service.Methods Using the non-random quota sampling method, the basic public health service utilization survey data of 2 736 floating populations were analyzed by unconditional univariate and multivariate logistic regression analysis. Results The utilization rate of the basic public health services of the floating population was 30.37%, which was significantly lower than the utilization rate of household registration population（ χ^2=98.05, P〈0.001）. Results from univariate analysis showed that marriage, education, income, medical insurance, the impression of community health service center,heard of basic public health services, health knowledge knowing level, service requirements and willingness of accepting public health service were related to utilization of basic public health service; Results from multivariate analysis showed that, heard of basic public health service project（OR=3.98）, basic public health services needs（OR=2.34）, owning medical insurance（OR=2.17）, having a good impression of community health service center（OR =1.64）, willing to cooperate with the community service center to receive free basic public health services project（OR=1.62） and high income（OR=1.37） were main influence factors. Conclusion The utilization of the basic public health service of the floating population is low and the two important factors which are imperfect health insurance system and deficient publicity play significant role.