600例老年缺牙患者延迟就医的现状及其影响因素分析

Delay of seeking medical treatment for 600 aged patients with missing teeth current status and associated factors

目的:调查邯郸市口腔医院65岁及以上缺牙患者延迟就医的现状及其影响因素,为邯郸市口腔卫生保健工作提供信息支持。方法:2017年5月至2018年5月,采用便利抽样法选择邯郸市口腔医院接诊的老年患者600例为研究对象,采用自制的患者一般情况问卷和就医情况问卷、社会支持评定量表对其进行调查分析,分析延迟就医的影响因素。结果:有效问卷512份,近1年内口腔科就诊率16. 01%,90%以上是因为急、慢性牙疼和其他口腔问题,进行定期口腔检查的人口比率极少,仅占0. 78%。51. 17%的居民选择大医院就诊,主要是医疗技术原因,占56. 10%。选择社区医院的原因中'距离近'是主要原因,占43. 62%,其次为'价格便宜',占39. 59%;影响口腔科老年患者延迟就医的主要因素是:有无医保、有无配偶、人均年收入、客观支持、主观支持、对支持的利用度、社会支持量表总分。结论:邯郸市老年缺牙患者延迟就医现象较为普遍,建议增强社区卫生服务能力,提高诊疗效率;提升医院医护水平,改善医疗服务态度;实行定制化医疗服务,完善居民健康管理体系,从而降低患者的延迟就医率。

Objective:To investigate the current situation and associated factors of delay of seeking medical treatment among patients aged 65 and over with missing teeth in Handan,so as to provide the informative basis of the establishment of oral health care policy in Handan.Methods:From May 2017 to May 2018,600 patients with oral disease were selected using convenience sampling method from stomatological hospital in Handan,the influencing factors of patient delay were assessed by the self-designed questionnaires of the general data,medical-seeking situation,social support.Results:512 questionnaires were eligible,only 16.1%people went to department of stomatology of hospital last year,and 90%patient were due to acute and chronic toothache or other discomforts,people with periodic oral examination was rarely(0.78%).51.17%of residents choose to superior hospital because of the high level of medical technology(56.10%).The short distance was the first reason for choosing community hospital(43.62%),the second reason was cheap(39.59%).Medical insurance,partner,economic income,objective support,subjective support,use of social support,social support were the associated factors for patient delay.Conclusion:The old patient with missing teeth delay of oral disease is comparatively common in Handan,the management of medical institutions should focus on enhancing the ability of community health services and efficiency of diagnosis and treatment;Hospital should improve the level of care and their service attitudes;Community health institutions should implement customized medical services and improve their health management systems.So as to reduce the patient delay rate.