社区居民健康相关生命质量对卫生服务利用的影响

Influence of Health-related Quality of Life on Health Service Utilization in Community Residents

目的:利用EQ-5D量表评价和分析18岁及以上社区居民健康相关生命质量,并研究健康相关生命质量对卫生服务利用的影响。方法 :基于中国EQ-5D效用值积分体系计算健康效用值,运用χ2检验分析EQ-5D各维度水平人群卫生服务利用情况,采用logistic回归分析影响卫生服务利用的因素。结果:居民两周就诊率和1年住院率分别为6.39%、7.02%。在EQ-5D的5个维度中,"疼痛/不舒服"对两周就诊的影响最大,OR 95%CI:3.31(2.74～4.00),"能否自我照顾"对1年住院的影响最大,OR95%CI:6.53 (5.22～8.16)。logistic回归结果显示,在调整人口学特征与卫生服务可及性等混杂因素情况下,健康效用值与EQ-VAS得分均能影响卫生服务利用。结论:居民健康相关生命质量影响卫生服务利用,健康效用值与EQVAS得分越高,卫生服务利用越低。

Objective:Using EQ-5D scale to evaluate and analyze the health-related quality of life(HRQoL)of community residents over 18 years old,and to explore the effects of HRQoL on health service utilization.Methods:Using Chinese EQ-5D social value to calculate the utility value of health status,Chi-square test was used to compare health service utilization among different groups.Logistic regressions were used to explore the risk factors of health service utilization.Results:The prevalence of recent two-week physician visit and annual hospitalization were 6.39%and 7.02%.In 5 dimensions of EQ-5D scale,pain/anxiety had the greatest impact on two-week physician visit,OR 95%CI:3.31(2.74.4.00),self-care had the greatest impact on annual hospitalization,OR95%CI:6.53(5.22-8.16).Logistic regression indicated that HRQoL would affect the health service utilization even after adjusting confounding factors such as social demographic variables and health service accessibility variables.Conclusion:HRQoL affected the health service utilization.With the increasing of utility value of health status and EQ-VAS score,the health service utilization decreased.