山东省老年人住院医疗服务利用情况及其影响因素分析

Lu Lu, Xiang Jing, Yali Wang, Y. Xia, Yaozu Li, An′an Jiao, Lingzhong Xu
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引用次数: 0

摘要

目的了解山东省老年人住院医疗服务利用情况,分析影响老年人住院医疗服务利用的因素,为老年人合理利用住院医疗服务提供参考。方法于2017年8月在山东省进行调查。采用多阶段分层整群随机抽样方法,选取山东省6个县区60岁及以上居民7 070人作为调查对象。调查内容包括老年人家庭、个人基本信息和住院服务利用情况。单因素分析采用卡方检验和秩和检验,影响因素采用logistic回归。结果山东省老年人年住院率为18.1%,有住院需求者中有9.6%未能享受到服务。80岁及以上老年人年住院率为19.9%,有需要的患者未住院率为5.5%。在住院机构中,乡镇卫生院/社区卫生服务中心、县(区)医疗机构、地级医疗机构和省级医疗机构的比例分别为29.2%、29.1%、37.7%和1.4%。影响老年人住院服务利用的因素包括年龄、健康自我评估、体检、慢性病、医疗保险类型和收入水平。结论应重视80岁及以上老年人的住院服务。应采取有效措施,引导老年人充分利用基层医疗资源。加强慢性病防治工作,促进老年人合理利用住院卫生服务。此外,应更多地关注低收入老年人,以满足其住院需求。关键词:卫生保健调查;幸运;住院治疗;服务使用;影响因素;山东
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Utilization of inpatient health care and its influencing factors among elderlies in Shandong province
Objective To investigate the utilization of inpatient health care among the elderlies in Shandong province, and to analyze the factors affecting the inpatient services utilization, so as to provide reference for the elderlies to utilize the inpatient services reasonably. Methods The survey was conducted in Shandong province in August 2017. Multi-stage stratified cluster random sampling method was used to select 7 070 residents aged 60 and above in 6 counties and districts of Shandong province as the objects of the survey. The survey included the basic family and personal information of the elderlies as well as the utilization of hospitalization services. Chi-square test and rank sum test were used for univariate analysis, and logistic regression was applied for influencing factors. Results The annual hospitalization rate of the elderlies in Shandong province was 18.1%, and 9.6% of those in need of hospitalization failed to enjoy the service. The annual hospitalization rate of the elderlies aged 80 years and over was 19.9%, and 5.5% of the patients in need had not been hospitalized. Among the inpatient institutions, the proportion of township health centers/community health service centers, county-level(district) medical institutions, prefecture-level medical institutions and provincial-level medical institutions was 29.2%, 29.1%, 37.7% and 1.4%, respectively.Factors influencing the utilization of hospitalization services for the elderlies included age, self-assessment of health, physical examination, chronic diseases, type of medical insurance and income level. Conclusions More attention should be paid to the hospitalization services for the elderlies aged 80 years and over. Effective measures should be taken to guide the elderlies to fully use primary medical resources. The prevention and control of chronic diseases should be strengthened to promote the rational use of inpatient health services among the elderlies. In addition, more attention should be paid to low-income elderlies to meet their hospitalization needs. Key words: Healthcare survey; Elderlies; Hospitalization; Service usage; Influencing factors; Shandong province
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