北京市城乡居民口腔卫生服务利用与费用影响因素分析

An analysis on the factors affecting the dental care utilization and expenditure of residents in Beijing

目的 通过对北京市居民口腔卫生利用和费用的定量研究及影响因素分析 ,为控制口腔费用的增长和建立口腔医疗保险制度提供依据。方法 分层、整群、随机抽取城乡居民 3395人进行调查 ,利用单变量Logistic回归、方差分析和三部模型方法进行口腔卫生服务利用和费用的因素分析。结果 城区 0～ 14岁儿童、享有保障制度和患病者的人群利用概率高 ,OR值分别为 5 .834、2 .72 1、1.793。低收入者利用概率低 ,高收入者就诊费用高 ,儿童的就诊费用较低。保障制度对农村居民口腔卫生服务利用几乎没有影响 ,影响居民就诊的主要因素是年龄、职业、患病状况和收入的高低 ,一旦利用口腔卫生服务 ,影响就诊费用的主要是不同的病种。结论 年龄是影响居民需求的主要因素 ,收入对个人是否就诊的决定有显著作用。保障制度对城乡居民的服务利用呈现相反的趋势 ,无论城乡居民 ,一旦利用口腔卫生服务 。

Objective To analyze the dental care utilization and expenditure and its affecting factors of residents in Beijing,and to provide some basis on the study of controlling the irrational increase of dental expenditure and establishing oral health insurance system.Methods 3395 subjects were selected by stratified,clustering,random sampling.Univariant Logistic regression method,ANOVA analysis and three-part model method were used to analyze the affecting factors on the dental care utilization and expenditure.Results In urban area,children aged 0～4 yrs,people with dental insurance coverage and the patients who had higher demand for dental care,had OR values 5.834 , 2.721 and 1.793 ,respectively,People with low income seldom visited a dentist.The expenditure for oral health care was high in those with high income,while it was low in children.In rural area,insurance system had no effect on the resident's demand for dental care.The main factors were age,occupation,income and disease itself.Once the dental services were available,the main factor was the different diseases they complained of.Conclusion Age was the main factor affecting the demand for dental care.Income had significant effect on the decision of visiting a dentist.Insurance had two-side effect on the demand for dental care of urban and rural residents.Once the dental services were utilized,oral health status was more important on affecting the frequency and expenditure for dental care.