厦门市慢性病患者公共卫生服务利用状况及干预对策探讨

Study on Utilization of Public Health Services and Intervention Strategy Among the Patients with Chronic Diseases in Xiamen

目的比较厦门市岛内外社区慢性病患者利用基本公共卫生服务的差异,探讨适合的干预对策。方法随机抽取岛内K社区和岛外X社区的1,009名慢性病患者进行入户访谈式问卷调查。结果岛内K社区与岛外X社区的慢性病患者在受教育程度、职业、家庭月收入、慢病知识知晓情况等方面存在显著性差异(P<0.01)。岛内K社区患者选择社区卫生服务中心首诊的比例(34.3%)低于岛外X社区(48.3%),岛内K社区患者在社区建立档案的比例(46.6%)低于岛外X社区(86.7%),岛内K社区患者与家庭医生签约的比例(8.1%)高于岛外X社区(2.1%),岛内K社区患者认为较常获得健康教育服务的比例(6.9%)低于岛外X社区(26.2%),各项差异均有统计学意义(P<0.01)。另外,被调查的高血压和高血糖患者中,岛内K社区患者参加社区卫生服务中心免费体检的比例均低于岛外X社区,懂得自测血压/血糖的比例均高于岛外X社区,差异有统计学意义(P<0.01)。结论两个社区慢性病患者利用公共卫生服务水平存在差异,需因地制宜,根据各自问题采用有针对性的干预对策。

Objective To compare the differences in the utilization of basic public health services of the patients with chronic diseases in two communities located inside and outside Xiamen Island respectively, so as to explore the appropriate intervention strategies. Methods A total of 1,009 patients with chronic diseases selected by using random sampling from K community(inside Island) and X community(outside Island) were interviewed by questionnaires. Results There were significant differences in the level of education, occupation, family income, awareness of chronic disease knowledge(P<0.01). The proportion of the patients with chronic diseases in K community(34.3%) who had the willingness to select first treatment in the community, was lower than that in X community(48.3%), the proportion of the patients with chronic diseases who established their personal files in K community(46.6%) was lower than that in X community(86.7%), the proportion of the patients with chronic diseases singed GP in K community(8.1%) was higher than that in X community(2.1%), the proportion of the patients with chronic diseases who often got the health education from community health services in K community(6.9%) was lower than that in X community(26.2%); the differences all above were statistically significant(P<0.01). In addition, among the patients with hypertension or hyperglycemia, the proportion of the patients who participated in free physical examination by community health services in K community was lower than X community, the proportion who knew how to measure their own blood pressures or glucose in K community was higher than that in X community, the differences were statistically significant(P<0.01). Conclusion There were differences in the ability of patients to use public health services between two communities. The government should adopt targeted intervention measures according to their respective problems.