【摘要】：通過調(diào)查和研究內(nèi)蒙古察右中旗農(nóng)牧區(qū)居民衛(wèi)生服務(wù)利用現(xiàn)狀,了解當(dāng)?shù)鼐用裥l(wèi)生服務(wù)利用水平及其影響因素,分析和探討當(dāng)前醫(yī)療衛(wèi)生環(huán)境下,內(nèi)蒙古察右中旗農(nóng)牧區(qū)居民的衛(wèi)生服務(wù)利用公平性程度,發(fā)現(xiàn)存在的問題以及薄弱環(huán)節(jié),為優(yōu)化衛(wèi)生資源配置、合理組織衛(wèi)生服務(wù)、提高衛(wèi)生服務(wù)利用效率、改善當(dāng)?shù)剞r(nóng)牧區(qū)居民衛(wèi)生服務(wù)利用公平性提出對策和建議,從而為提高農(nóng)牧區(qū)居民健康水平和促進衛(wèi)生事業(yè)進一步發(fā)展提供客觀依據(jù)。對象和方法:以內(nèi)蒙古自治區(qū)察右中旗的常住居民為調(diào)查對象,開展居民家庭衛(wèi)生服務(wù)利用詢問調(diào)查。調(diào)查采用隨機抽樣方法,隨機抽取察右中旗4個鄉(xiāng)鎮(zhèn)蘇木321戶家庭。調(diào)查問卷參考國家衛(wèi)生計生委設(shè)計的居民家庭健康詢問調(diào)查表,并對居住一年以上的農(nóng)牧區(qū)居民進行問卷調(diào)查。采用SPSS20.0統(tǒng)計軟件進行處理分析數(shù)據(jù)。影響因素分析采用Pearson卡方檢驗和Logistic回歸分析方法。通過集中指數(shù)來測算衛(wèi)生服務(wù)利用公平性。結(jié)果:1.調(diào)查對象兩周患病率為19.86%,低于全國第五次衛(wèi)生服務(wù)調(diào)查農(nóng)村、城市地區(qū)兩周患病率20.2%和28.2%。2.調(diào)查對象兩周就診率為10.59%,低于第五次衛(wèi)生服務(wù)調(diào)查農(nóng)村、城市地區(qū)兩周就診率12.8%和13.3%;兩周未就診率為26.67%,略低于全國第五次衛(wèi)生服務(wù)平均未就診率27.3%,患病后兩周患者自我治療所占比例較高。3.調(diào)查對象過去一年住院率為14.05%,高于全國第五次衛(wèi)生服務(wù)調(diào)查城市、農(nóng)村地區(qū)住院率,分別為9.1%和9.0%;調(diào)查對象需住院未住院率為24.63%,高于第五次衛(wèi)生服務(wù)調(diào)查農(nóng)村和城市未住院率,造成農(nóng)牧區(qū)居民未住院的首要原因顯示為經(jīng)濟困難。4.調(diào)查對象兩周患病后首選就診醫(yī)療機構(gòu)中,地市級醫(yī)療機構(gòu)和私人診所就診比例較高,鄉(xiāng)鎮(zhèn)衛(wèi)生院就所占比例最低;不同類型住院機構(gòu)顯示,旗縣級衛(wèi)生機構(gòu)住院比例最高,鄉(xiāng)鎮(zhèn)衛(wèi)生院所占比例最低。5.集中指數(shù)分析結(jié)果顯示,不同人均年收入組調(diào)查對象的兩周就診率的集中指數(shù)是0.05665,絕對值較大,提示門診衛(wèi)生服務(wù)利用公平性較弱;調(diào)查對象住院率集中指數(shù)顯示為0.00133,絕對值接近0,提示不同人均年收入組調(diào)查對象住院衛(wèi)生服務(wù)利用相對公平。6.多因素Logistic回歸分析顯示,影響居民衛(wèi)生服務(wù)利用的因素有性別、年齡、醫(yī)保類型,不同收入水平以及到達最近醫(yī)療點的距離。結(jié)論:1.調(diào)查對象兩周就診率低于全國第五次衛(wèi)生服務(wù)調(diào)查的水平,表明衛(wèi)生服務(wù)利用水平較低;兩周患病患者自我治療比例較高,未住院率高于第五次衛(wèi)生服務(wù)調(diào)查水平,表明衛(wèi)生服務(wù)需要量較大。2.調(diào)查顯示患者就醫(yī)流向不合理,鄉(xiāng)鎮(zhèn)衛(wèi)生院利用水平較偏低,農(nóng)村基層醫(yī)療衛(wèi)生機構(gòu)利用率受限。3.新農(nóng)合在一定程度上刺激了居民的住院衛(wèi)生服務(wù)利用水平,但調(diào)查顯示經(jīng)濟狀況是制約調(diào)查對象應(yīng)住院未住院的主要原因。4、調(diào)查地區(qū)醫(yī)療衛(wèi)生服務(wù)可及性差,可及性是影響居民診療概率的重要因素。5、調(diào)查顯示住院衛(wèi)生服務(wù)利用公平性要優(yōu)于門診,門診衛(wèi)生服務(wù)利用的公平性要引起重視。
[Abstract]:Through the investigation and study of the status of health service utilization in the rural and pastoral areas of Inner Mongolia Zhongli Zhongqi, the level of local residents' health service utilization and its influencing factors were understood, and the fairness of health service utilization in the rural and pastoral areas of Inner Mongolia was analyzed and discussed under the current medical and health environment, and the problems and weak links were found. In order to optimize the allocation of health resources, rationally organize health services, improve the utilization efficiency of health services, improve the fairness of local health service in the local agricultural and pastoral areas, put forward the countermeasures and suggestions to improve the health level of the residents in the agricultural and pastoral areas and promote the further development of health services. The resident residents of right Zhongqi were investigated. The investigation of household health service utilization was carried out. A random sampling method was used to randomly select 321 families of 4 villages and towns in the Middle Banner of right. The questionnaire referred to the household health inquiry questionnaire designed by the state health planning committee, and the residents living in the farm and pastoral areas for more than one year. Questionnaire survey was carried out. SPSS20.0 statistical software was used to process analysis data. The analysis of influencing factors was based on Pearson chi square test and Logistic regression analysis. The fairness of health services was measured by the concentration index. Results: 1. the prevalence rate of two weeks was 19.86%, which was lower than the country's fifth health service survey in rural areas and urban areas. The two week prevalence rate of 20.2% and 28.2%.2. was 10.59% for two weeks, which was lower than fifth times of health service investigation in rural areas, two weeks in urban areas was 12.8% and 13.3%, and 26.67% was not found in two weeks, slightly below the average rate of non medical treatment of fifth health services in China, and the proportion of self treatment in two weeks after illness was higher.3.. The rate of hospitalization in the past year was 14.05%, which was higher than that of the fifth health service survey cities in the country. The rate of hospitalization in rural areas was 9.1% and 9%, and the rate of hospitalization was 24.63%, which was higher than that of fifth health services. The primary reason for the non hospitalization of farmers and pastoral areas was economic difficulties. The proportion of local medical institutions and private clinics was higher in the medical institutions of first choice after two weeks of disease, and the proportion of township health centers was the lowest. Different types of hospitalization institutions showed that the proportion of the hospital in Qixian level health institutions was the highest, and the lowest.5. concentration index of Township health centers showed that different people were different. The concentration index of the two weeks consultation rate of the average annual income group was 0.05665, the absolute value was large, which suggested that the utilization of health service was weak in the outpatient service; the concentration index of the hospitalization rate of the respondents was 0.00133 and the absolute value was close to 0, suggesting that the hospital health service of different per capita income groups used a relatively fair.6. multiple factor Logistic. The regression analysis showed that the factors affecting the utilization of health service were gender, age, medical insurance type, different income level and the distance to the nearest medical point. Conclusion: 1. the two weeks' rate of medical treatment was lower than the level of the national fifth health service survey, indicating that the utilization level of health service was low; the ratio of self treatment to patients in the two weeks was compared. The non hospitalization rate was higher than that of fifth times of health service investigation. It showed that the.2. survey showed that the flow of medical services was not reasonable, the utilization level of township hospitals was low, and the utilization rate of rural grassroots medical institutions was limited by.3. NCMS to some extent, to a certain extent, the level of hospital health service utilization was stimulated. But the survey showed that the economic situation is the main reason that restrict the investigation object should not be hospitalized.4, the investigation area medical and health service is poor, the accessibility is an important factor that affects the diagnosis and treatment probability of the residents.5. The investigation shows that the fairness of the hospital health service is better than the outpatient service, and the fairness of the health service utilization of the door consultation should be paid more attention.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.1

【相似文獻】

相關(guān)期刊論文 前10條

1 劉曉強,馬材芳;江蘇省衛(wèi)生服務(wù)利用狀況分析[J];衛(wèi)生經(jīng)濟研究;2002年05期

2 魏繼炳,王謙,肖永富,汪少英,邱加閩,覺嘎,李光清;四川省藏族牧區(qū)主要疾病以及衛(wèi)生服務(wù)利用狀況[J];中國初級衛(wèi)生保健;2003年01期

3 汪少英,王謙,魏繼炳,肖永富,邱加閩,覺嘎,李光清;四川省藏區(qū)牧民衛(wèi)生服務(wù)利用的局限以及改進機會參與式研究[J];中國初級衛(wèi)生保健;2003年01期

4 盧祖洵,劉軍安,彭績,程錦泉,楊德華,夏挺松;深圳市社區(qū)衛(wèi)生服務(wù)利用及其影響因素分析[J];中華醫(yī)院管理雜志;2005年07期

5 方敏霞;醫(yī)科大學(xué)生衛(wèi)生服務(wù)調(diào)查[J];解放軍醫(yī)院管理雜志;2005年02期

6 孫曉杰;孫強;孟慶躍;尹愛田;楊柳;郭有禮;;甘肅省四縣農(nóng)村居民衛(wèi)生服務(wù)利用狀況比較研究[J];中國衛(wèi)生事業(yè)管理;2006年04期

7 雷衛(wèi)河;張智民;王耀平;時松和;田慶豐;;河南省農(nóng)民住院衛(wèi)生服務(wù)利用狀況及影響因素分析[J];中國衛(wèi)生統(tǒng)計;2006年03期

8 肖峰;馬軍;榮湘江;呂巖玉;丁小燕;羅曉;臧振君;陳博文;;北京市亞運村社區(qū)衛(wèi)生服務(wù)利用現(xiàn)況調(diào)查[J];中國公共衛(wèi)生;2007年05期

9 張耀光;張拓紅;高軍;徐玲;;城市不在業(yè)者衛(wèi)生服務(wù)利用及影響因素分析[J];中國衛(wèi)生統(tǒng)計;2007年02期

10 馮金;賈翠學(xué);劉志堅;;鹽池縣城鎮(zhèn)非醫(yī)保居民衛(wèi)生服務(wù)利用狀況分析[J];寧夏醫(yī)科大學(xué)學(xué)報;2009年05期

相關(guān)會議論文 前6條

1 劉海霞;鐘曉妮;周燕榮;田考聰;;決策樹在居民就診衛(wèi)生服務(wù)利用影響因素研究中的應(yīng)用[A];重慶市預(yù)防醫(yī)學(xué)會2010年論文集[C];2011年

2 郭平;程建鵬;尚曉援;;中國城鄉(xiāng)老年人健康狀況與衛(wèi)生服務(wù)利用的差異[A];中國老齡科學(xué)研究中心2004年度優(yōu)秀論文集[C];2004年

3 車剛;趙濤;;新型農(nóng)村合作醫(yī)療對農(nóng)村居民衛(wèi)生服務(wù)利用公平性的影響研究[A];農(nóng)村衛(wèi)生改革與發(fā)展研討會論文集[C];2006年

4 趙錫銀;;居民對社區(qū)衛(wèi)生服務(wù)利用程度是社區(qū)衛(wèi)生建設(shè)的金標(biāo)準(zhǔn)[A];中國中西醫(yī)結(jié)合學(xué)會管理專業(yè)委員會學(xué)術(shù)會議論文集[C];2007年

5 白瑞;沈其君;唐立健;;嵌套logit模型在衛(wèi)生服務(wù)利用影響因素分析中的應(yīng)用[A];應(yīng)對突發(fā)公共衛(wèi)生事件論壇論文集[C];2005年

6 盧美林;;新型農(nóng)村合作醫(yī)療制度面臨的主要問題與對策[A];農(nóng)村衛(wèi)生改革與發(fā)展研討會論文集[C];2006年

相關(guān)重要報紙文章 前4條

1 記者 葛云峰 特約記者 焦曉寧;陜西社區(qū)衛(wèi)生服務(wù)利用率顯著提高[N];健康報;2012年

2 閻紅;沈陽啟動貧困人口醫(yī)療救助[N];健康報;2003年

3 張楠;窮縣農(nóng)牧民衛(wèi)生得保障[N];中國財經(jīng)報;2006年

4 記者 董克偉;專家建議建立流動人口醫(yī)療救助制度[N];中國改革報;2007年

相關(guān)博士學(xué)位論文 前6條

1 李昱;農(nóng)村老齡人口健康、醫(yī)療服務(wù)利用和費用及其與新農(nóng)合關(guān)系研究[D];山東大學(xué);2015年

2 肖亞洲;湖南某縣農(nóng)村留守老年人生活質(zhì)量與衛(wèi)生服務(wù)利用研究[D];中南大學(xué);2010年

3 陳天輝;健康相關(guān)生命質(zhì)量（HRQoL）對慢性病患者衛(wèi)生服務(wù)利用影響的研究[D];浙江大學(xué);2006年

4 孫曉杰;社會資本與城市居民健康公平的關(guān)系[D];山東大學(xué);2008年

5 王文華;基層照護視角下病人就診體驗評價及與健康自評、滿意度的關(guān)系研究[D];山東大學(xué);2014年

6 譚志軍;人群健康測量與評價方法研究—復(fù)雜抽樣與EQ-5D測量[D];第四軍醫(yī)大學(xué);2014年

相關(guān)碩士學(xué)位論文 前10條

1 段姚堯;武警部隊某高校大學(xué)生衛(wèi)生服務(wù)利用研究[D];河北醫(yī)科大學(xué);2015年

2 米婧婧;2013年與2011年昆明市主城區(qū)社區(qū)衛(wèi)生服務(wù)利用情況比較研究[D];昆明醫(yī)科大學(xué);2015年

3 王平平;吉林省城鄉(xiāng)居民衛(wèi)生服務(wù)利用公平性研究[D];吉林大學(xué);2016年

4 李越;我國居民衛(wèi)生服務(wù)利用預(yù)測和公平性研究[D];山東大學(xué);2016年

5 王成蓬;山東省老年人衛(wèi)生服務(wù)利用研究[D];山東大學(xué);2016年

6 閆夢青;河南省居民衛(wèi)生服務(wù)利用及公平性研究[D];鄭州大學(xué);2016年

7 李佳蔓;重慶市城鄉(xiāng)老年人衛(wèi)生服務(wù)利用與醫(yī)療費用變化研究[D];重慶醫(yī)科大學(xué);2016年

8 辛冉;美沙酮維持治療門診服藥人員HCV感染及相關(guān)衛(wèi)生服務(wù)利用情況研究[D];中國疾病預(yù)防控制中心;2016年

9 劉雪嬌;絕對貧困人口健康收入效應(yīng)及衛(wèi)生服務(wù)利用研究[D];華中師范大學(xué);2016年

10 王杰;云南省昭通市農(nóng)村居民衛(wèi)生服務(wù)利用公平性研究[D];昆明醫(yī)科大學(xué);2016年

，

本文編號：2119665