慢性病管理视角下吉林省基本公共卫生服务覆盖现状及影响因素分析

Coverage and influential factors of national basic public health service in Jilin province under implementation of chronic disease management

目的从慢性病管理视角分析吉林省国家基本公共卫生服务覆盖情况及其影响因素。方法采用吉林省2008与2013年国家卫生服务调查家庭健康询问调查数据,以≥18岁调查人口为研究对象,描述慢性病相关基本公共卫生服务的覆盖现状及趋势;采用logistic回归模型分析其影响因素。结果与2008年比较,2013年慢性病相关基本公共卫生服务覆盖率有所提高,慢性病患者健康体检率由22.52%增至53.59%、高血压患者健康教育率由63.51%增至66.63%,血压规范监测率由82.56%增至93.13%;与农村地区相较,城市地区健康体检、血压规范监测服务覆盖率较高(OR=1.5,P<0.01;OR=2.3,P<0.01),建档率和高血压患者健康教育率较低(OR=0.3,P<0.01;OR=0.6,P<0.01)。个人文化程度、家庭人均收入、社会医疗保险类型、年龄与部分基本公共卫生服务覆盖相关。结论慢性病管理视角下,吉林省基本公共卫生服务慢性病管理相关措施覆盖面在5年内有所改善,但仍未达到“全面覆盖”的目标。

Objective To analyze the coverage and influential factors of the national basic public health service (BPHS) in Jilin province from the perspective of chronic disease management.Methods Using the household survey data on residents aged ≥ 18 years from the fourth and fifth wave of the National Health Services Survey conducted in 2008 and 2013 in Jilin province, we described the coverage of and the change in BPHS and analyzed influential factors of BPHS coverage with logistic regression model.Results Compared to that in 2008, the coverage of chronic disease-related BPHS had been improved in 2013;the rate of health checkup for the patients with chronic diseases increased from 22.52% to 53.59%;the rate of health education increased from 63.51% to 66.63% and the rate of regular blood pressure monitoring increased from 82.56% to 93.13% in the hypertensives. In comparison with those among the rural residents, the rate of the health checkup and regular blood pressure monitoring among urban residents were higher (odds ratio [OR]= 1.5, P < 0.01;OR = 2.3, P < 0.01), but the rate of health record establishment and the rate of health education in the hypertensives were lower (OR = 0.3, P < 0.01;OR = 0.6, P < 0.01). The coverage of some BPHS items are associated with personal education, family income, type of medical insurance, and age among the residents.Conclusion The coverage of the basic public health services in Jilin province has been improved from 2008 to 2013, but it has not reached the goal of universal coverage, with the gaps between different population groups.