流动人口慢性病患者公共卫生服务利用现状及影响因素

Utilization status and influencing factors of public health services for chronic disease patients in floating population

目的了解流动人口慢性病患者公共卫生服务利用现状,并分析其影响因素,为进一步促进国家基本公共卫生服务均等化提供参考依据。方法利用2017年全国流动人口卫生计生动态监测调查中患高血压或(和)2型糖尿病的流动人口数据,了解流动人口慢性病患者公共卫生服务(健康档案建档、健康教育服务和随访服务)利用情况。采用SPSS20.0进行χ2检验,对流动人口慢性病患者公共卫生服务利用情况的影响因素进行多因素logistic回归分析。结果共纳入9272名研究对象,流动人口慢性病患者健康档案建档率为32.0%,健康教育服务利用率为63.2%,随访服务利用率为36.4%。多因素logistic回归分析结果显示,在流动人口慢性病患者中,女性(OR=1.156),60岁及以上(OR=1.652),少数民族(OR=1.196),受教育程度为初中(OR=1.390)、高中或中专(OR=1.438)和大专及以上(OR=1.532),流动范围为省内跨市(OR=1.480)和市内跨县(OR=1.794),流动原因为经商(OR=1.125)和其他(OR=1.175),到达最近医疗服务机构时间<15 min(OR=1.168)是利用健康档案建档服务的有利因素;受教育程度为小学(OR=1.266)、初中(OR=1.474)、高中或中专(OR=1.563)和大专及以上(OR=1.707),流动范围为省内跨市(OR=1.244)和市内跨县(OR=1.432),流动原因为经商(OR=1.321)和自评基本健康(OR=1.158)是利用健康教育服务的有利因素;女性(OR=1.187),年龄为45~59岁(OR=1.388)和60岁及以上(OR=2.296),少数民族(OR=1.329),受教育程度为高中或中专(OR=1.223),流动范围为省内跨市(OR=1.314)和市内跨县(OR=1.385),到达最近医疗服务机构时间小于15 min(OR=1.120),自评基本健康(OR=1.364)和自评健康(OR=1.436)是利用随访服务的有利因素,均有统计学意义(P<0.05,P<0.01)。结论流动人口慢性病患者卫生服务利用水平较低,应加强基本公共卫生服务的针对性,促进基本公共卫生服务均等化。

Objective To understand the utilization status and influencing factors of public health services for chronic disease patients in floating population,and to provide the reference basis for further promoting the equalization of national basic public health services.Methods The data of hypertension or type 2 diabetes mellitus(T2 DM)patients from dynamic monitoring survey of health and family planning of floating population in China of 2017 were used to investigate the utilization conditions of public health services for chronic disease patients in floating population(health files,health education service and following up service).Theχ~2 test was used to analyze the data,the multivariate logistic regression analysis was used to analyze the utilization influencing factors of public health services for chronic disease patients in floating population,the used software was SPSS 20.0.Results A total of 9272 subjects were included.In the floating population with chronic diseases,the health file rate was 32.0%,the utilization rate of health education services was 63.2%,and the follow-up service utilization rate was 36.4%.The multivariate logistic regression analysis showed that the favorable factors for utilization of the health file service in floating population with chronic diseases were female(OR=1.156),age≥60 years old(OR=1.652),ethnic minority(OR=1.196),educational levels(junior high school OR=1.390,senior high school or secondary school OR=1.438,junior college or above OR=1.532),the mobile range(intercity in the province OR=1.480,inter-county in the city OR=1.794),the mobile reasons(business OR=1.125,others OR=1.175),arrival time<15 min(OR=1.168)to the nearest medical service institution;the favorable factors for utilization of health education services were education levels(primary school OR=1.266,junior high school OR=1.474,senior high school or secondary school OR=1.563,junior college or above OR=1.707),the mobile range(inter-city in the province OR=1.244,inter-county in the city OR=1.432),the mobile reason(business OR=1.321)and basic health reported by self-assessment(OR=1.158);the favorable factors for utilization of follow-up service were female(OR=1.187),45-59 years old(OR=1.388),≥60 years old(OR=2.296),the ethnic minorities(OR=1.329),educational level(senior high school or secondary school OR=1.223),the mobile range(inter-city in the province OR=1.314,inter-county in the city OR=1.385),arrival time<15 min(OR=1.120)to the nearest medical service institution,the basic health(OR=1.364)and health reported by self-assessment(OR=1.436),P<0.05 or P<0.01.Conclusion The health service utilization level of the floating population with chronic diseases was lower.Therefore,the pertinence of basic public health services should be strengthened,and measures should be taken to promote the equalization of the utilization of basic public health service.