河南省贫困居民住院服务利用状况及多水平影响因素分析

Analyzing the Status of Hospitalization Services Utilization of Poverty Residents in Henan and Its Multi-level Influencing Factors

目的:了解河南省贫困居民住院服务利用状况及影响因素。方法:采用多阶段分层整群随机抽样的方法对河南省居民进行家庭健康询问调查,描述贫困人口住院服务利用情况,并利用广义线性混合模型对住院服务利用的影响因素进行多水平分析。结果:2008-2018年,贫困居民住院率分别为13.40%、13.44%、24.58%,未住院率分别为46.67%、32.96%、28.41%;经济困难是未住院的主要原因;脑血管病、高血压病、其他类型心脏病占贫困人口全部住院人次的31.23%、30.38%、33.67%;贫困人口基层机构住院比例高于非贫困人口。多水平分析结果显示,贫困人口住院在家庭水平有聚集性;户口性质、年龄、文化程度、就业状况、健康状况评分、健康体检、慢性病是影响河南省贫困居民住院的因素。结论:贫困人口住院服务利用状况改善,经济困难仍是影响居民卫生服务利用的重要因素;加强慢性病管理,重视健康教育,提高全体居民健康水平。

Objective To study the status of hospitalization services utilization of poverty residents in Henan and its influencing factors.Methods A multi-stage stratified cluster random sampling method was used to conduct family health inquiry survey on residents in Henan Province.The influencing factors were analyzed by generalized linear mixed model.Results From 2008 to 2018,the hospitalization rate of poverty residents was 13.40%,13.44% and 24.58%,respectively,and the non-hospitalization rate was 46.67%,32.96% and 28.41%,respectively.Economic difficulty was the main reason for not being hospitalized.Cerebrovascular disease,hypertension and other types of heart disease accounted for 31.23%,30.38% and 33.67% of all hospi-talized diseases of the poor population,respectively.The proportion of poor hospitalized in primary institutions was higher than that of non poor people.The results of multi-level analysis showed that the poverty residents were clustered at the family level.The nature of household registration,age,education level,employment status,health status score,physical examination and chronic diseases were the influencing factors.Conclusion The utilization of hospitalized services of the poor has been improved.And economic difficulty is still the important factors to influence the utilization of health services.It is suggested to strengthen the management of chronic diseases,value health education on poor residents to improve the health of all residents.