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李伟豪, 申洋, 王芳, 朱赫, 刘胜兰, 娜荷芽, 王梦楠, 常春. 城市老年人基本公共卫生服务利用影响因素多水平模型分析[J]. 中国公共卫生, 2019, 35(1): 71-75. DOI: 10.11847/zgggws1117323
引用本文: 李伟豪, 申洋, 王芳, 朱赫, 刘胜兰, 娜荷芽, 王梦楠, 常春. 城市老年人基本公共卫生服务利用影响因素多水平模型分析[J]. 中国公共卫生, 2019, 35(1): 71-75. DOI: 10.11847/zgggws1117323
Wei-hao LI, Yang SHEN, Fang WANG, . Utilization of essential public health service and its influencing factors among urban elderly people: a multilevel model analysis[J]. Chinese Journal of Public Health, 2019, 35(1): 71-75. DOI: 10.11847/zgggws1117323
Citation: Wei-hao LI, Yang SHEN, Fang WANG, . Utilization of essential public health service and its influencing factors among urban elderly people: a multilevel model analysis[J]. Chinese Journal of Public Health, 2019, 35(1): 71-75. DOI: 10.11847/zgggws1117323

城市老年人基本公共卫生服务利用影响因素多水平模型分析

Utilization of essential public health service and its influencing factors among urban elderly people: a multilevel model analysis

  • 摘要:
      目的  探索城市老年人基本公共卫生服务的利用现状及影响因素,为进一步完善服务、提高其利用率提供参考。
      方法  通过两阶段随机抽样,选取北京市东城区1 530名≥65岁老年人进行问卷调查,了解该群体对以社区免费健康体检为代表的基本公共卫生服务的利用情况,并应用多水平模型分析其影响因素。
      结果  研究对象免费健康体检利用率为46.7 %。多水平模型显示,所在社区卫生服务机构等级高(OR = 1.92)是免费体检利用的促进因素;个体年龄在70~75岁(OR = 1.39)、患有慢性病(OR = 1.47)、退休前职业为专业技术人员(OR = 1.43)、听说过基本公共卫生服务(OR = 1.48)、了解公共卫生服务信息的主要途径为医生与居委会(OR = 2.24、1.56)是体检利用的促进因素,而个人月收入在4 000~4 999元与≥5 000元(OR = 0.51、0.23)与在其他机构体检过(OR = 0.66)为阻碍因素。
      结论  城市≥65岁老年人免费健康体检利用率较低;社区层面与个人层面两水平因素共同影响该群体对基本公共卫生服务的利用。 建议除加强对基本公共卫生服务的宣传力度、改进宣传模式外,还需加大对社区卫生服务机构的投入、提高体检服务质量与吸引力,以进一步提高老年人对基本公共卫生服务的利用率,促进老年人口健康。

     

    Abstract:
      Objective  To explore current situation and influencing factors of utilization of essential public health service (UEPHS) among urban elderly people and to provide references for improving UEPHS.
      Methods  A total of 1 530 residents aged 65 years and over were selected in 51 communities in Dongcheng district of Beijing municipality with two-stage random sampling. A face-to-face questionnaire survey was conducted to collect information on participation of physical examination free of charge provided by community health service centers/stations as a indicator of UEPHS among the participants between December 2016 and January 2017. Multilevel model was used to analyze influencing factors of UEPHS.
      Results  Of the participants, 46.7% reported participating in the free physical examination. The multilevel model analysis indicated that with the community health service provided by medical institutions at higher administration level was a promoting factor for the elderly’s participation in the examination (odds ratio OR = 1.92). For the participants, those aged 70 to 75 years (OR = 1.39), suffering from non-communicable chronic diseases (NCD) (OR = 1.47), being a technical personnel before retire (OR = 1.43), being aware of UEPHS (OR = 1.38), and receiving UEPHS-related information mainly through doctors and community facilities (OR = 2.24 and OR = 1.56) were more likely to take part in the physical examination free of charge; while those with the personal monthly income of 4 000 – 4 999 and > 5 000 RMB yuan (OR = 0.51 and OR = 0.23) and those ever having taken a physical examination provided by other medical institutions were less likely to receive the examination.
      Conclusion  The utilization rate of physical examination free of charge was relatively low and both community and individual factors affected the UEPHS among the urban community elderly 65 years old or more. The results suggest effective measures are needed to improve the UEPHS for health promotion among urban elderly community population.

     

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