山东省流动人口健康档案建立和患病就诊现状及其影响因素分析

Health record establishment, seeking medication and their impact factors in migrant population in Shandong province

目的了解山东省流动人口居民健康档案建立和患病就诊现状及其影响因素,为增强流动人口的健康水平、促进医疗卫生服务的可及性及公平性提供参考建议。方法收集2017年5—8月山东省流动人口动态监测数据中在山东省居住时间≥1个月的6000名≥15周岁流动人口的相关数据,并应用SPSS 22.0统计软件分析山东省流动人口居民健康档案建立和患病就诊现状及其影响因素。结果山东省6000名流动人口中,建立居民健康档案者2488人,居民健康档案建档率为41.47%;过去1年患腹泻、发热、皮疹、黄疸、结膜红肿、感冒等疾病者3646例,就诊者1250例,患病就诊率为34.28%。多因素非条件logistic回归分析结果显示,婚姻状况为非在婚是山东省流动人口建立居民健康档案的危险因素,女性、流动范围为省内流动、愿意落户和参加城镇职工医疗保险是山东省流动人口建立居民健康档案的保护因素;年龄较大、自评基本健康和健康是山东省流动人口患病就诊的危险因素,参加新型农村合作医疗保险、城镇职工医疗保险和其他医疗保险是山东省流动人口患病就诊的保护因素。结论山东省流动人口居民健康档案建档率和患病就诊率均较低,性别、年龄、婚姻状况、流动范围、落户意愿、自评健康状况和参加医疗保险情况是该地区流动人口建立居民健康档案和患病就诊的主要影响因素。

Objective To explore the status quo and influencing factors of health record establishment and seeking medication in migrant population in Shandong province, and to provide evidences for improving the health of migrant people and promoting accessibility and equity of health care services. Methods From the dataset of dynamic surveillance on migrant population, we extracted relevant information on health record establishment and seeking medication for 6 000 migrant people aged ≥ 15 years and living in Shandong province at least one month between May and August 2017.Descriptive statistics was performed on the data collected with SPSS 22.0 software. Results Among all the included migrant people, 2 488(41.47%) had their health records being established. Of the 3 646 people suffering from diseases as diarrhea,fever, rash, jaundice, conjunctival swelling, and cold during the past one year, 1 250(34.28%) sought medication.Unconditional multivariate logistic regression analysis demonstrated that the migrants being unmarried were less likely to have their health records being established;while, the migrants being female, migrating within the province, having the willingness to settle in the immigratory place, and participating in medical insurance for urban workers were more likely to have their health records being established;the migrants at older age and with a general self-rated health were less likely to seek medication but the migrants participating in the new rural cooperative medical insurance or medical insurance for urban workers and other medical insurance were more likely to seek medication while suffering from diseases. Conclusion Both the ratio of health record establishment and seeking medication are low among migrant population in Shandong province and the ratios are influenced by gender, age, marital status, regional scope of migration, willingness of resettlement, self-rated health, and the participation in medical insurance.