基于Anderson模型的山东省农村高血压患者预防保健和卫生服务利用的影响因素分析

Analysis of Influencing Factors of Rural Hypertensive Patients' Utilization of Prevention and Health Services in Shandong Province Based on Anderson's Behavioral Model

目的:利用安德森卫生服务利用行为模型分析山东省农村高血压患者预防保健和卫生服务利用的影响因素。方法:对山东省673名农村高血压患者进行问卷调查和定性访谈,分析结果。结果:高血压患者规范化管理率为78.3%,两周就诊率为9.8%。规范化管理患者更多见于女性、25-54岁、黄岛区和曲阜、自感健康状况中和差、患慢性病≥2种、不吸烟者、不饮酒者组。利用卫生服务的患者更多见于女性、25-54岁、青岛市和曲阜市、家庭收入1-2和>2万元以上、自感健康状况中和差、患慢性病≥2种、不吸烟者、不饮酒者、与医疗机构距离<1 km组。结论:山东省农村高血压患者规范化管理率和两周就诊率亟待提高。基层全科医生应采取生活方式干预、健康教育、上门服务等综合措施提高卫生服务公平可及性。

Objective： To analyze factors affecting the prevention and health care utilization among hypertensive patients in rural areas of Shandong Province based on Anderson’s behavioral model of health service use. Methods： 673 rural hypertensive patients were surveyed by face-to-face questionnaire surveys and qualitative interviews in Shandong Province and the results were analyzed. Results： Among the hypertensive patients, the standardized management rate were 78.3%, and the two-week visiting rate was 9.8%. The hypertensive patients who were female, aged 25-54 years old, lived in Huangdao District or Qufu City, with poorer perceived health, with more than two types of chronic diseases, non-smokers and non-drinkers had a better hypertension standardized management. The hypertensive patients who were female, aged 25-54 years old, lived in Huangdao District or Qufu City, with poorer perceived health, with more than two types of chronic diseases, non-smokers and non-drinkers, with family income 10,000-20,000 yuan or more than 20,000 yuan and with the distance to the nearest medical establishment 〈1 km used more health services. Conclusion： The rates of standardized hypertensive management and two-week visiting rate need to be improved promptly. General practitioners should perform lifestyle-qualification intervention, health education, home service supplied to the patients with limited physical mobility and other comprehensive measures to improve the equity and availability of health service.