浙江省城乡居民门诊服务利用影响因素分析

An Analysis for the Utilization of the Out-patient Clinic Serve of City and Countryside Residents in Zhejiang Province

目的 分析浙江省城乡居民门诊医疗服务的影响因素。方法 利用 1998年浙江省卫生服务调查12个县、区 72 0 0户家庭询问调查的资料 ,采用logistic回归分析 ,建立概率模型。结果 在城市居民中 ,影响居民 2周就诊概率的因素有年龄 <15岁、慢性重症疾病、有公费医疗、有劳保医疗、有半劳保医疗 ,OR值分别为 6 3 0、 3 79、 2 81、 2 2 2、 1 97;农村 2周就诊概率影响因素有年龄 <15岁、急性重症、慢性重症、急性轻症、慢性轻症等 ,OR值分别为 1 71、 3 5 9、 1 97、 1 42、 1 63 ,减低就诊概率的有离医疗点距离超过 2公里、患有慢性疾病、长期失能等 ,OR值分别为 0 45、 0 62、 0 64。结论 城市要加强社区卫生服务 ,完善医疗保险制度 ;而农村应着重解决卫生服务的可得性和农村居民经济困难看不起病的问题。

Objective To analysis the influence factors of out patient clinic serve utilization of city and countryside residents in Zhejiang province.Methods The data of 12 county and districts including 7200 families which were investigated in the health serve investigation in 1998,was used to create the probability model by the method of logistic regression.Results The influence factors of city residents were age less than 15,chronic serious illness,public medical care,labor medical care and half labor medical care,with the value of OR 6 30,3 79,2 81,2 22 and 1 97 respectively.The influence factors of countryside residents were age less than 15,acute serious illness,chronic serious illness,acute and chronic general sick,with the value of OR1 71,3 59,1 97,1 42 and 1 63 respectively.The factors reducing the probability of clinic serve were distance more than 2 kilometers,chronic desease and long term disability,with the value of OR 0 45,0 62 and 0 64 respectively.Conclusions It is necessary to strengthen the community health serve and to improve the medical insurance system in city,and to solve the problem of unavailable health serve and to improve poor economic condition which results to affording difficulty in medical care in the countryside.