西部某地区居民卫生服务利用研究

Research of Healthcare Utilization Among Residents in a Region of Western China

目的调查与分析西部某地区居民的卫生服务利用。方法在西部某地区选取4个县,在各县随机抽取两个乡镇进行入户调查。通过描述性分析和logistic回归,分析居民的卫生服务利用及其影响因素。结果共回收有效问卷3973份。村卫生室、乡镇卫生院和县级医院承担了调查前两周91.3%的门诊服务。乡镇卫生院和县级医院承担了调查前一年76.2%的住院服务。民族、文化程度、总体健康状况、被医生确诊为高血压或其他慢性病影响门诊就诊率。性别、年龄、是否购买商业医疗保险、总体健康状况、被医生确诊为糖尿病或其他慢性病影响住院率。结论居民就诊集中在县域内部。应积极推动县域医共体的建立,完善家庭医生签约服务,不断提升县域卫生服务供给能力和慢性病管理水平。

Objective To investigate the healthcare utilization among residents in a region of western China.Methods Four counties were selected in a region of western China.In each county,two townships were randomly selected for a household survey.Healthcare utilization among residents was analyzed through descriptive analysis.Influencing factors of health service utilization were analyzed using logistic regressions.Results A total of 3973 valid questionnaires were collected.In the past two weeks,91.3%of reported outpatient care took place in village health clinics,town⁃ship health centres and county-level hospitals.In the past year,76.2%of reported inpatient care took place in town⁃ship health centres and county-level hospitals.Influencing factors of utilizing outpatient services included ethnicity,education level,overall health status,and having hypertension or other chronic disease diagnoses.Gender,age,commercial medical insurance coverage,overall health status,and having diabetes or other chronic disease diag⁃noses were influencing factors of hospitalization.Conclusion Healthcare utilization among residents was concentrated in the county-level medical institutions.County-level integrated care groups should be established actively.Further,im⁃prove the health services of family doctors and continuously improve the service capability at the county-level and chronic diseases management at the grassroots level.