中国老年居民门诊就诊和住院现状及其影响因素分析

Outpatient visits and hospitalizations and their associates among community-dwelling older adults in China:2018

目的了解中国老年居民的门诊就诊和住院现状及其影响因素,为完善我国老年人群医疗卫生服务提供相关科学依据。方法收集老年期重点疾病预防和干预项目(PINDEC)2018年7—10月北京市、上海市、湖北省、四川省、云南省、广西壮族自治区6个地区17985名≥60岁老年居民的追踪随访数据,分析过去1年老年居民的门诊就诊和住院情况及其主要影响因素。结果中国17985名老年居民中,过去1年到门诊就诊者9073例,经复杂加权后门诊就诊率为48.3%;过去1年住院者3799例,经复杂加权后住院率为23.2%。多因素非条件logistic回归分析结果显示,年龄70~79岁、参与社会活动、患≥2种慢性病及抑郁症状和运动障碍阳性是中国老年居民门诊就诊的危险因素,月均收入1000~2999元、邻里密切交往、会上网及所在地区为湖北省、四川省、云南省和广西壮族自治区是中国老年居民门诊就诊的保护因素;年龄70~79岁、所在地区为云南省、参与社会活动、患≥2种慢性病及抑郁症状和运动障碍阳性是中国老年居民住院的危险因素,主要收入来源为工作收入和邻里密切交往是中国老年居民住院的保护因素。结论中国老年居民门诊就诊率和住院率均较高,年龄、月均收入、主要收入来源、地区、邻里交往、社会活动、是否会上网、患慢性病种数、抑郁症状情况和运动障碍情况是我国老年居民门诊就诊和住院的主要影响因素。

Objective To investigate the status and influencing factors of outpatient visits and hospitalizations among community older residents in China for providing evidences to the improvement of medical healthcare in elderly populations.Methods The data on 17985 community-dwelling people aged 60 years and over in six provincial level regions(Beijing,Shanghai,Hubei,Sichuan,Yunnan,Guangxi Zhuang Autonomous Region)across China were extracted from the Prevention and Intervention on Neurodegenerative Disease for Elderly in China(PINDEC)conducted during July–October,2018.The outpatient visits and hospitalizations of the residents during past one year and their impact factors were analyzed.Results Of all participants during past one year,9073 had outpatient visits,with a complex weighted outpatient visit rate of 48.3%;3799 had hospitalizations and the complex weighted hospitalization rate was 23.2%.The results of multivariate unconditional logistic regression analyses indicated that aged 70–79 years,participating in social activities,suffering from two or more chronic diseases,with depression symptoms or movement disorders were risk factors for outpatient visits;while with monthly personal income of 1000–2999 RMB yuan,having frequent communication with neighbors,being capable of web surfing,and residing in Hubei,Sichuan,Yunnan or Guangxi Zhuang Autonomous Region were protective factors;the results also revealed that the risk factors for hospitalization in past one year included aged 70–79 years,residing in Yunnan,participating in social activities,suffering from two or more chronic diseases,and with depression symptoms or movement disorders and the two significant protective factors were with salary as main income source and having frequent communication with neighbors.Conclusion Among community elderly residents in China,both outpatient visit and hospitalization are at a high level generally and mainly influenced by age,average monthly income,major source of income,residing region,communication with neighbors,participation in social activities,internet access,multimorbidity of chronic diseases,depression symptom,and movement disorder.