云南省彝族居民卫生服务利用公平性研究

Analysis on equity of health care utilization of Yi nationality in Yunnan

[目的]对云南省彝族居民卫生服务利用及其公平性进行分析,为彝族居民进一步提高健康水平提供依据,提出应将医疗卫生服务资源向低收入及高龄人群倾斜,加强健康教育,促进健康状况改善。[方法]采用分阶段分层整群随机抽样方法,选取年龄16岁以上的彝族居民进行现场问卷调查。用两周就诊率、慢性病就诊率、住院率反映卫生服务利用情况,用χ~2检验和集中指数CI分析卫生服务利用的公平性。[结果]彝族居民的两周就诊率为6.22%,不同年龄和职业的两周就诊率比较存在统计学差异(P<0.05);慢性病就诊率为11.26%,不同年龄、文化程度、婚姻情况和职业的慢性病就诊率比较存在统计学差异(P<0.05);住院率为10.67%,不同性别、年龄和婚姻情况的住院率比较存在统计学差异(P<0.05);不同年龄、经济收入人群中,其门诊服务利用的公平性存在差异。[结论]彝族居民的卫生服务利用情况较低,且存在不公平性,应关注老年人、文化程度低者、离婚或丧偶者。

Objective To analyze the equity of health care utilization of Yi nationality in Yunnan, and provide basis for promoting the health of Yination - ality. It puts forward that we should trend health care service resource to low income and aged group. Strengthen health education, promote health condition. Methods Cluster sampling method was used to sample. Household surveys were conducted by face - to - face interviews with questionnaire to more than 16 years old Yi nationality residents. It reflected the equity of health care utilization through two weeks out- patient rate, rate of chronic disease and hospitalization. Chi - square test and concentration Index were used to analyze the equity of health care utilization. Results Two weeks outpatient rate was 6. 22%. There was statistical difference in comparing different age and occupation of two weeks outpatient rate （P 〈 0. 05 ） . Chronic diseases outpatient rate was 11. 26% , There was statistical difference in in comparing different age, education degree, marital status and occupation of chronic disease outpatient rate （P 〈 0. 05 ） . Hospitalization rate was 10. 67% , there was statistical difference in comparing different sex, age and marital status of hospitalization rate （ P 〈 0.05 ） . In different age, income groups, there was difference in the equity of health care utilization. Conclusions Health care utilization of Yi nationality was low and existed unfairness. We should pay more attention to the aged, low education degree and divorced or widows or widowers.