流动老人常见病就诊及健康档案建立情况的影响因素分析

Influencing factors for medical visits of elderly migrant patients for common diseases and health record establishment

目的了解流动老人常见病就诊及健康档案建立情况,并探讨其影响因素,为增强流动老人健康水平和社会保障水平,促进医疗卫生服务利用可及性提供相关建议。方法对6478名流动老人的基本情况进行统计描述,采用频数、百分比指标描述流动老人常见病患病就诊情况和健康档案建立情况,采用卡方检验、二分类logistic回归模型对流动老人常见病就诊和健康档案建立情况的影响因素进行统计分析。结果流动老人的患病就诊率仅为36.91%,居民健康档案建档率为31.11%。回归分析结果显示,影响流动老人患病就诊的主要因素有受教育程度、自评健康状况和参加医疗保险情况(P<0.05),小学及以下学历、身体基本健康和不健康、参加新型农村合作医疗保险、城镇职工医疗保险以及其他医疗保险的流动老人患病就诊情况较好;影响流动老人建立健康档案的主要因素有性别、年龄、流动范围、参加医疗保险情况、社会保障卡办理情况(P<0.05),女性、年龄大、省内流动、参加其他医疗保险、办理社会保障卡的流动老人建档情况较好。结论流动老人的常见病患病就诊及健康档案建立情况欠佳,应加强对流动老人医疗卫生服务利用及健康档案建立与管理的重视。

Objective To investigate the influencing factors for medical visits of migrant elderly for common diseases and establishment of health records so as to provide suggestions for improving the health and social security and promote the accessibility of medical and health services.Methods The basic information of 6478 migrant elderly was statistically described.Frequency and percentage indicators were used to analyze the medical visits of the migrant elderly for common diseases and the establishment of health records.Chi-square test and binary logistic regression model were used to analyze the influencing factors statistically.Results The medical visit rate of the migrant elderly was only 36.91%,and the rate of residents'health records establishment was 31.11%.Regression analysis results showed that the main factors affecting the medical visits were education level,self-rated health status and participation in medical insurance(P<0.05).Migrant elderly with primary school education and below,who were basically healthy and unhealthy,and who enjoyed the new rural cooperative medical system,urban employee medical insurance and other medical insurances had a higher frequecy of medical visits;the main factors affecting the establishment of health records for migrant elderly were gender,age,mobility scope,participation in medical insurance,and social security card application status(P<0.05).Women,old age,migrants in the province,participating in other medical insurances,and having social security card were positive factors for establishment of medical records.Conclusion Medical visit and health records establishment in migrant elderly patients for common diseases is inferior.The utilization of medical and health services for migrant elderly and the establishment and management of health records should be emphasized.