苏北农村老年人健康状况及卫生服务需求分析

Health status and healthcare service needs for the rural elderly population in Northern Jiangsu

目的了解苏北农村老年人健康状况、卫生服务需求现况并探讨其影响因素。方法采用多阶段分层整群抽样，对徐州市和连云港市、宿迁市60岁及以上的老年人进行面对面问卷调查。调查苏北农村老年人健康状况与卫生服务需求及的影响因素。结果共调查老年人2 655人，男1 252人（47.2%），女1 403人（52.8%），平均（70.9±6.7）岁。老年人健康自评差，2周患病率为26.6%，慢性病患病率为60.1%，46.5%的老年人经常服药，4.1%的老年人有生理失能，8.2%的老年人日常生活活动能力有损害。两周患病就诊率为29.4%，1年内住院率为18.5%，应住院而未住院率为27.6%。多因素分析显示年龄大（OR＝5.51）、收入够用（OR＝2.29）、去医疗机构用时短（OR＝7.90）的老年人2周就诊率高，年龄大（OR＝1.76）、女性（OR＝1.36）、空巢（OR＝1.37）、家庭和睦（OR＝1.91）、患慢性病（OR＝3.49）、经常服药（OR＝1.69）等住院率高。 结论苏北农村老年人健康状况差，卫生服务需求水平高，实际利用不足。

ObjectiveTo study the health status, the current health service needs and the influencing factors concerning the rural elderly population in Northern Jiangsu.MethodsMulti-stage stratified cluster sampling was conducted in elderly people over 60 in Xuzhou, Lianyungang, and Suqian.Participants were face-to-face interviewed with questionnaires.Information on health status and health service needs was collected and analyzed.ResultsA total of 2655 elderly people were enrolled in this study, including 1252 males（47.2%）and 1403（52.8%）females with a mean age of（70.9±6.7）years.Self-assessed health was generally poor, with the two-week morbidity at 26.6% and the prevalence of chronic diseases at 60.1%; 46.5% of the participants regularly took medications; 4.1% of them had physical disability; 8.2% had impaired daily activities; The two-week hospital visit rate was 29.4%; The one-year hospitalization rate was 18.5%; The rate of non-hospitalization for people in need of hospitalization was 27.6%.Multivariate analysis showed that old age（OR=5.51）, adequate income（OR=2.29）and short journey to a medical institution（OR=7.90）were associated with high two-week hospital visit rates; old age（OR=1.76）, female gender（OR=1.36）, empty-nest（OR=1.37）, family harmony（OR=1.91）, having chronic diseases（OR=3.49）, and high frequency in taking medications（OR=1.69）were correlated with high hospitalization rates.ConclusionsThe elderly population in rural areas of Northern Jiangsu shows poor health, has high needs for health services, and lacks sufficient service utilization.