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杨晓倩, 秦江梅, 张丽芳, 张艳春, 张幸, 林春梅. 高血压、糖尿病患者预防和医疗服务利用影响因素分析[J]. 中国公共卫生, 2017, 33(2): 185-190. DOI: 10.11847/zgggws2017-33-02-04
引用本文: 杨晓倩, 秦江梅, 张丽芳, 张艳春, 张幸, 林春梅. 高血压、糖尿病患者预防和医疗服务利用影响因素分析[J]. 中国公共卫生, 2017, 33(2): 185-190. DOI: 10.11847/zgggws2017-33-02-04
YANG Xiao-qian, QIN Jiang-mei, ZHANG Li-fang.et al, . Utilization of prevention and health care service and its influencing factors among hypertensive and diabetic patients[J]. Chinese Journal of Public Health, 2017, 33(2): 185-190. DOI: 10.11847/zgggws2017-33-02-04
Citation: YANG Xiao-qian, QIN Jiang-mei, ZHANG Li-fang.et al, . Utilization of prevention and health care service and its influencing factors among hypertensive and diabetic patients[J]. Chinese Journal of Public Health, 2017, 33(2): 185-190. DOI: 10.11847/zgggws2017-33-02-04

高血压、糖尿病患者预防和医疗服务利用影响因素分析

Utilization of prevention and health care service and its influencing factors among hypertensive and diabetic patients

  • 摘要: 目的 分析高血压和糖尿病患者预防服务(规范化管理)、门诊及住院服务利用情况及影响因素。方法 利用2014年“基层卫生综合改革重点联系点”需方家庭健康询问调查数据,建立高血压、糖尿病患者分析数据库,分析高血压、糖尿病患者规范化管理、门诊及住院服务利用情况,并进行单因素χ2检验和多因素logistic回归分析。结果 共调查≥15岁人口53 337人,其中高血压患者9 607人,糖尿病患者2 640人,规范化管理率分别为80.2%和78.3%,两周就诊率分别为41.3%和57.3%,住院率分别为33.2%和52.7%;多因素logistic回归分析结果显示,高血压和糖尿病患者接受规范化管理的主要影响因素为签约服务、年龄、城乡类型和地区等;门诊服务利用的主要影响因素为参加医疗保险类型、慢性病门诊补偿、文化程度、就业状况、城乡类型和地区等;住院服务利用的主要影响因素为收入水平、慢性病门诊补偿、文化程度、城乡类型和地区。结论 签约服务可促进高血压和糖尿病患者接受规范化管理;参加城镇职工医保慢性病患者门诊服务利用率低,住院服务利用率高;慢性病门诊补偿政策能有效促进高血压和糖尿病患者留在门诊,减少住院。

     

    Abstract: Objective To analyze the utilization of outpatient and inpatient prevention service,a part of standardized management,and its influencing factors among hypertension and diabetes patients.Methods Data on the utilization of outpatient and inpatient prevention service among 9 607 hypertension patients and 2 640 diabetic patients were extracted from the dataset of the Household Questionnaire Survey on Health sponsored by The National Health and Family Planning Commission and the Ministry of Finance and conducted in 2014 in 34 key counties or districts for comprehensive health reform across China.Chi-square test and multivariate logistic regression model were adopted in data analysis.Results Among the hypertension and diabetes patients,the standardized management rate were 80.2% and 78.3%;the rate of visiting a doctor during past two weeks was 41.3% and 57.3%;and the hospitalization rate was 33.2% and 52.7%,respectively.The results of multivariate logistic regression analyses showed that the main influencing factors were whether having community family physician service,age,residential place (urban or rural),and region of residence (eastern,central,or western China) for the acceptance of standardized management;type of medical insurance,compensation for utilization of outpatient service for chronic disease,education,employment status,and residential place were influencing factors for the utilization of outpatient service;and income,compensation for chronic disease outpatient service,education,and region of residence were influencing factors for the utilization of hospitalization.Conclusion Community family physician service could promote standardized management of hypertension and diabetes patients.Hypertension and diabetes patients with medical insurance for urban employees had a lower utilization rate of outpatient service but a higher utilization rate of hospitalization.The compensation for utilization of outpatient service for chronic disease could effectively facilitate utilization of outpatient service but decrease hospitalization among hypertension and diabetes patients.

     

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