山东省农村多重慢病患者卫生服务利用现状及影响因素分析

Analysis of the Utilization of Health Services for Patients with Multimorbidity in Rural Shandong and Its Influencing Factors

目的:分析山东省农村多重慢病患者卫生服务利用现状及影响因素,为制定相关政策提供参考。方法:采用多阶段随机抽样方法选取山东省2县(市)共16个村共531名多重慢病患者进行问卷调查,通过描述性分析、二元logistics回归分析等方法分析样本地区卫生服务利用情况。结果:农村多重慢病患者两周就诊率为115.6%,主要就诊机构为村卫生室(72.7%);年住院率为43.1%,应住院未住院率为14.2%;年人均慢性病医疗自付费用4885.0元。性别、家庭收入、自评健康状况是门诊就诊利用的影响因素,共病组合数量是影响住院服务利用的因素。结论:多重慢病患者卫生服务利用率较高,卫生需求仍得不到充分满足。应加强共病综合治理,提升基层诊疗水平,提高居民健康意识。

Objective To investigate the utilization of health service for patients with multiple chronic diseases in rural Shandong and its influencing factors,so as to provide references for making relevant policies.Methods A total of 531 patients with multiple chronic diseases were selected from 16 villages in 2 counties(cities)of Shandong Province by multistage random sampling method for questionnaire survey.Statistical analysis methods such as descriptive analysis and logistic regression were used to analyze the utilization of health services in the sample areas.Results The two-week visit rate was 115.6%,mainly in village clinics(72.7%).The annual hospitalization rate was 43.1%.14.2%of the patient with diseases should be hospitalized didn’t be hospitalized.The annual per capital out-of-pocket medical expenses for chronic diseases was 4885.0 Yuan.Gender,family income and self-rated health status were the influencing factors of outpatient service utilization,while the number of multimorbidity was the influencing factor of inpatient service utilization.Conclusion The utilization rate of health services for patients with multiple chronic diseases was high,while their health needs were still not fully met.It is suggested to strengthen comprehensive management of multimorbidity,improve the level of diagnosis and treatment at the grassroots level,and enhance the residents’health awareness.