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钟怀昌, 熊海, 周亚希, 等. 西藏地区城乡居民卫生服务利用影响因素对比分析[J]. koko体育app 学报(医学版), 2023, 54(5): 985-993. DOI:
引用本文: 钟怀昌, 熊海, 周亚希, 等. 西藏地区城乡居民卫生服务利用影响因素对比分析[J]. koko体育app 学报(医学版), 2023, 54(5): 985-993. DOI:
ZHONG Huaichang, XIONG Hai, ZHOU Yaxi, et al. Comparative Analysis of Influencing Factors of Health Service Utilization Among Urban and Rural Residents in Tibet[J]. Journal of Sichuan University (Medical Sciences), 2023, 54(5): 985-993. DOI:
Citation: 𒀰 ZHONG Huaichang, XIONG Hai, ZHOU Yaxi, et al. Comparative Analysis of Influencing Factors of Health Service Utilization Among Urban and Rural Residents in Tibet[J]. Journal of Sichuan University (Medical Sciences), 2023, 54(5): 985-993. DOI:

西藏地区城乡居民卫生服务利用影响因素对比分析

Comparative Analysis of Influencing Factors of Health Service Utilization Among Urban and Rural Residents in Tibet

  • 摘要:
      目的  探讨西藏地区城乡居民卫生服务利用影响因素的差异与共性,确定卫生服务利用的弱势人群,从而为当地卫生政策的制定和卫生资源的配置提供参考。
      方法  利用西藏地区国家第六次卫生服务调查数据,采取χ2检验及logistic回归模型对收集到的8297名农牧区居民及2179名城镇居民的卫生服务利用现状进行统计学分析。
      结果  农牧区、城镇居民两周患病医疗机构就诊率分别为65.3%、57.1%,一年住院率分别为8.3%、8.9%。农牧区居民两周患病医疗机构就诊的影响因素有:城乡医保、三保合一、就诊距离、是否患慢性病、体检、家庭医生签约、就业和健康自评,城镇居民两周患病医疗机构就诊的影响因素有:是否患慢性病、城乡医保、健康自评、健康档案和体检;农牧区居民住院的影响因素有:性别、年龄、婚姻、城乡医保、三保合一、大病统筹医保、健康自评、行动能力、健康档案、体检和是否患慢性病;城镇居民住院的影响因素有:性别、婚姻、健康自评、健康档案、城镇职工医保和是否患慢性病。
      结论  西藏地区城乡居民健康状况相对较差,且患病后及时就诊的意识相对薄弱,相关卫生部门应重视卫生服务利用的弱势人群,重点从城乡居民共有的卫生服务利用影响因素入手,兼顾差异性,合理配置卫生资源,提高西藏地区居民卫生服务有效利用率。
     
    Abstract:
      Objective   To examine the differences and commonalities of factors influencing the utilization of health services among urban and rural residents in Tibet and to identify vulnerable populations in the utilization of health services, thereby providing references for the formulation of local health policies and the allocation of health resources.
      Methods   Using the Tibetan area data from the Sixth National Health Service Survey, we conducted statistical analysis of the health service utilization status of 8297 residents of agro-pastoral areas and 2179 residents of urban areas with χ2 test and logistic regression model.
      Results   The two-week outpatient visit rates of residents in agro-pastoral areas and that of the urban residents were 65.3% and 57.1%, respectively, and the one-year hospitalization rates were 8.3% and 8.9%, respectively. The influencing factors of two-week outpatient visits for rural and pastoral residents included urban and rural health insurance coverage, Three Guarantees in One coverage, distance to medical facilities, chronic disease status, physical examination, family doctor contract status, employment status, and health status self-assessment. The influencing factors of two-week outpatient visit for urban residents included chronic disease status, urban and rural medical insurance coverage, health status self-assessment, health records, and physical examination. The factors influencing hospitalization for agro-pastoral residents were sex, age, marital status, urban and rural medical insurance coverage, Three Guarantees in One coverage, critical illness insurance, health self-assessment, mobility, health records, physical examination, and chronic disease status. The factors influencing the hospitalization of urban residents were sex, marital status, health status self-assessment, health records, urban employee medical insurance coverage, and chronic disease status. The factors influencing the hospitalization of urban residents were sex, marital status, health status self-assessment, health records, urban employee medical insurance coverage, and chronic disease status.
      Conclusion   The urban and rural residents in Tibet have relatively poor health and their awareness of seeking early medical help after they fall ill is relatively weak. The health institutions concerned should dedicate more attention to the vulnerable populations who have difficulty accessing health services, focus on the commonly shared influencing factors of health service utilization among urban and rural residents, take into account the differences, rationally allocate health resources, and improve the effective utilization rate of health services among residents in Tibet.
     
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