基于安德森卫生服务利用行为模型的济南市乳腺癌患者预防保健及卫生服务利用的影响因素分析

Analysis of Influencing Factors of health service utilization of breast cancer screening in Ji'nan Based on Anderson's Behavioral Model

目的利用安德森卫生服务利用行为模型分析济南市乳腺癌筛查卫生服务利用的影响因素。方法针对济南市1824例适龄女性进行问卷调查,从倾向特征、使能资源、需求因素及健康行为等方面,分析乳腺癌筛查卫生服务利用的影响因素。结果在此研究中,乳腺癌筛查服务利用率为65.46%。多因素logistic回归分析显示:乳腺癌服务利用更多见于城镇[OR=0.606,95%CI(0.451,0.814)]、高中以上学历[高中/大专:OR=5.624,95%CI(1.872,16.89);本科及以上:OR=7.001,95%CI(2.239,21.893)]、在业[OR=0.284,95%CI(0.108,0.751)]、愿意主动接受筛查[OR=0.593,95%CI(0.437,0.805)]、听说过两癌筛查[OR=0.129,95%CI(0.072,0.232)]、家庭总收入8万以下[OR=1.081,95%CI(0.78,1.499)]、患慢病[OR=0.622,95%CI(0.394,0.982)]、使用雌激素类药物组[OR=0.241,95%CI(0.092,0.631)]。结论倾向特征、使能资源、需求因素及健康行为不同程度地影响着妇女乳腺癌筛查卫生服务利用,建议相关部门加强健康知识宣教,继续提高医疗服务可及性,完善医疗保障制度,增强女性健康意识。

Objective To analyze factors affecting the health service utilization of breast cancer screening in Jinan based on Anderson's behavioral model of health service use.Methods A questionnaire survey was conducted among 1824 women of appropriate age in Ji'nan City to analyze the influencing factors of health service utilization of breast cancer screening from the aspects of predisposing characteristics,enabling resources,need and the use of health services.Results Among the women of the right age,the utilization rate of breast cancer screening services were 65.46%.Multivariate logistic regression analysis showed that:The women of the right age who were towns[OR=0.606,95%CI(0.451,0.814)],high school graduate or above[high school/junior college:OR=5.624,95%CI(1.872,16.89);bachelor degree or above:OR=7.001,95%CI(2.239,21.893)],employed[OR=0.284,95%CI(0.108,0.751)],willing to take the initiative to receive screening[OR=0.593,95%CI(0.437,0.805)],heard the screening of"two cancer"[OR=0.129,95%CI(0.072,0.232)],less than 80 thousand of the total family income[OR=1.081,95%CI(0.78,1.499)],suffering from chronic diseases[OR=0.622,95%CI(0.394,0.982)]and used estrogen drugs[OR=0.241,95%CI(0.092,0.631)]used more health services.Conclusion Predisposing characteristics,enabling resources,need and the use of health services affect the health service utilization of breast cancer screening in women to different degrees.Therefore,relevant departments should strengthen the education of breast cancer,improve the accessibility of medical services and the medical insurance system to enhance the health awareness of women.