河北省农村老年人医疗服务利用及影响因素

Utilization and influencing factors of health services for the elderly in rural areas of Hebei province

目的了解河北省农村老年人医疗服务利用现状及影响因素。方法于2021年8—9月采用随机分层法选取河北省1395名农村老年人为研究对象,以安德森行为模型为分析框架,采用Logistic回归模型分析倾向因素、能力因素、利用因素对农村老年人医疗服务利用的影响。结果农村老年人偶尔使用一般医疗服务1029人(73.76%);1年内住院医疗服务利用654人(46.88%)。Logistic回归分析结果显示,年龄(70岁以上)、婚姻状况(单身)2个倾向因素,到医疗机构距离1 km及以上、到医疗机构所需时间10 min以内、商业保险、家庭功能、主观支持5个能力因素,健康状况及生理健康、共病指数2个利用因素,是农村老年人医疗服务的影响因素(P<0.05,P<0.01)。结论河北省农村老年人的一般医疗服务利用较低,住院医疗服务利用处于中等水平,对医疗服务基本满意;倾向因素、能力因素和利用因素可影响医疗服务利用。

Objective To understand the current situation and influencing factors of medical service utilization for the elderly in rural areas of Hebei province.Methods From August to September 2021,1395 rural elderly people in Hebei province were conveniently selected by random stratification as the research objects.Anderson behavioral model was used as the analysis framework and Logistic regression model was used to analyze the influence of propensity factors,ability factors and utilization factors on the utilization of medical services for rural elderly people.Results Among the elderly in rural areas,1029(73.76%)people occasionally used general medical services;654(46.88%)people used inpatient medical services within one year.Logistic regression analysis results showed that age(over 70 years old),marital status(single)were two propensity factors,the distance to the medical institution was 1 km or more,the time required to arrive at the medical institution was less than 10 minutes,the commercial insurance,family function,subjective support 5 ability factors,health status and physical health,comorbidity index 2 utilization factors were the influencing factors of medical services for the elderly in rural areas(P<0.05,P<0.01).Conclusion The utilization of general medical services among the elderly in rural areas in Hebei province is low,the utilization of inpatient medical services is at a medium level,and they are basically satisfied with medical services.Tendency factors,ability factors and utilization factors affect the utilization of medical services.