“健康中国”背景下某市中老年居民就医方式及其影响因素研究

Medical consultation approaches and influencing factors of middle-aged and elderly residents in a city under the background of“Healthy China”strategy

目的了解某市中老年(40岁以上)居民医疗需求、利用现状和患病后就医方式,探讨影响就医方式选择的因素,以期引导中老年居民形成正确的就医模式。方法采用多阶段分层随机抽样方法将某市6个行政村(居委会)766名年龄≥40岁的户籍居民作为调查对象,通过问卷调查收集数据,描述中老年居民卫生服务需求及利用现状、患病后就医方式选择行为并分析及其影响因素。结果中老年居民慢性病患病率为74.5%,两周患病率为47.7%,两周就诊率为12.5%,两周患病就诊率为26.3%。患病后有161人选择医院就诊(21%),有455人选择自我医疗(59.4%),有150人选择不做任何治疗(19.6%)。经无序多分类Logistic回归分析发现,婚姻状态、体检、健康档案、获取健康知识频率和医疗类型偏好等因素影响着中老年居民的就医方式。结论中老年居民卫生服务需求量较大但卫生服务利用率不足,患病不就医现象严重,急需采取有效措施引导居民合理就医。

Objective To explore the current medical demand,utilization and medical consultation methods of middle-aged and elderly(≥40 years old)residents in a city of China and its influencing factors,in order to guide residents to form a correct medical consultation model.Methods A multi-stage stratified random sampling method was adopted to take 766 registered residents aged over 40 years old from 6 administrative villages(neighborhood committees)in a city as respondents.Data were collected through questionnaires to analyze the health service demand and utilization of middle-aged and elderly residents,their choice of medical consultation and its influencing factors after illness.Results The incidence of chronic diseases was 74.5%.The two-week prevalence rate,medical consultation rate and rate of medical consultation due to illness within two weeks were 47.7%,12.5%and 26.3%,respectively.After illness,161 patients chose hospital treatment(21%),455 patients chose self-treatment(59.4%),and another 150 patients chose no treatment(19.6%).Disordered multiclassification Logistic regression analysis results showed that marital status,physical examination,health records,the frequency of acquiring health knowledge and medical type preference influenced the medical consultation methods of middle-aged and elderly residents.Conclusions The demand for health services of middle-aged and elderly residents is large but the utilization rate of health services is insufficient.The phenomenon of not seeking medical advice for illness is serious.It is urgent to take effective measures to guide middle-aged and elderly residents to seek medical advice reasonably.