河北省农村老年人医疗服务利用及影响因素

doi:10.3969/j.issn.1674-490X.2022.06.011

医学研究与教育 ›› 2022, Vol. 39 ›› Issue (6): 65-74.DOI: 10.3969/j.issn.1674-490X.2022.06.011

河北省农村老年人医疗服务利用及影响因素

庞琳,井坤娟,尹园园,杜小静,董天行

河北大学护理学院, 河北保定 071000

收稿日期:2022-08-23 出版日期:2022-12-25 发布日期:2022-12-25
通讯作者: 井坤娟(1963—),女,河北安国人,教授,硕士,硕士生导师,主要从事老年护理及慢性病护理的教学和科研。E-mail: jingkunjuan@qq.com
作者简介:庞琳(1998—),女,河北保定人,在读硕士,主要从事慢性病护理研究。 E-mail: 330299435@qq.com
基金资助:
河北省发展和改革委员会2021年度第二批“三农”领域研究课题(HBQH2021029)

Received:2022-08-23 Online:2022-12-25 Published:2022-12-25

摘要/Abstract

摘要： 目的了解河北省农村老年人医疗服务利用现状及影响因素。方法于2021年8—9月采用随机分层法选取河北省1 395名农村老年人为研究对象,以安德森行为模型为分析框架,采用Logistic回归模型分析倾向因素、能力因素、利用因素对农村老年人医疗服务利用的影响。结果农村老年人偶尔使用一般医疗服务1 029人(73.76%);1年内住院医疗服务利用654人(46.88%)。Logistic回归分析结果显示,年龄(70岁以上)、婚姻状况(单身)2个倾向因素,到医疗机构距离1 km及以上、到医疗机构所需时间10 min以内、商业保险、家庭功能、主观支持5个能力因素,健康状况及生理健康、共病指数2个利用因素,是农村老年人医疗服务的影响因素(P<0.05,P<0.01)。结论河北省农村老年人的一般医疗服务利用较低,住院医疗服务利用处于中等水平,对医疗服务基本满意;倾向因素、能力因素和利用因素可影响医疗服务利用。

关键词: 农村老年人, 医疗服务利用, 安德森行为模型

Abstract: Objective To understand the current situation and influencing factors of medical service utilization for the elderly in rural areas of Hebei province. Methods From August to September 2021, 1 395 rural elderly people in Hebei province were conveniently selected by random stratification as the research objects. Anderson behavioral model was used as the analysis framework and Logistic regression model was used to analyze the influence of propensity factors, ability factors and utilization factors on the utilization of medical services for rural elderly people. Results Among the elderly in rural areas, 1 029(73.76%)people occasionally used general medical services; 654(46.88%)people used inpatient medical services within one year. Logistic regression analysis results showed that age(over 70 years old), marital status(single)were two propensity factors, the distance to the medical institution was 1 km or more, the time required to arrive at the medical institution was less than 10 minutes, the commercial insurance, family function, subjective support 5 ability factors, health status and physical health, comorbidity index 2 utilization factors were the influencing factors of medical services for the elderly in rural areas(P<0.05, P<0.01). Conclusion The utilization of general medical services among the elderly in rural areas in Hebei province is low, the utilization of inpatient medical services is at a medium level, and they are basically satisfied with medical services. Tendency factors, ability factors and utilization factors affect the utilization of medical services.

Key words: rural elderly, medical service utilization, Anderson behavioral model

中图分类号:

R473.2

庞琳,井坤娟,尹园园,杜小静,董天行. 河北省农村老年人医疗服务利用及影响因素[J]. 医学研究与教育, 2022, 39(6): 65-74.

参考文献

[1] 中华人民共和国国家统计局. 2020年第七次全国人口普查公报解读[EB/OL].(2021-5-19)[2022-07-15].http://www.stats.gov.cn/tjsj/sjjd/202105/t20210512_1817336.html.
[2] ZHANG J, LI D, GAO J M. Health disparities between the rural and urban elderly in China: a cross-sectional study[J]. Int J Environ Res Public Health, 2021, 18(15): 8056. DOI: 10.3390/ijerph18158056.
[3] 贺梦璐,王春霞,王海鹏,等.山东省农村多重慢病患者卫生服务利用现状及影响因素分析[J].中国卫生事业管理, 2021, 38(12): 922-925, 935.
[4] 孙秀娜,秦殿菊,徐静,等.河北省农村老年人卫生服务需要、需求及利用现状[J].中国公共卫生, 2022, 38(4): 420-424.
[5] 王启晨,姚俊.江苏省农村贫困居民卫生服务现状与影响因素研究[J].南京医科大学学报(社会科学版), 2019, 19(2): 133-137.
[6] 李月娥,卢珊.医疗卫生领域安德森模型的发展、应用及启示[J]. 中国卫生政策研究, 2017, 10(11): 77-82. DOI: 10.3969/j.issn.1674-2982.2017.11.013.
[7] SCHWARZER R, MUELLER J, GREENGLASS E. Assessment of perceived general self-efficacy on the Internet: data collection in cyberspace[J]. Anxiety Stress Coping, 1999, 12(2): 145-161. DOI: 10.1080/10615809908248327.
[8] 王才康,胡中锋,刘勇.一般自我效能感量表的信度和效度研究[J].应用心理学, 2001, 7(1): 37-40.
[9] SMILKSTEIN G, ASHWORTH C, MONTANO D. Validity and reliability of the family APGAR as a test of family function[J]. J Fam Pract, 1982, 15(2): 303-311.
[10] 肖水源.《社会支持评定量表》的理论基础与研究应用[J].临床精神医学杂志, 1994, 4(2): 98-100.
[11] WARE J Jr, KOSINSKI M, KELLER S D. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity[J]. Med Care, 1996, 34(3): 220-233. DOI: 10.1097/00005650-199603000-00003.
[12] LAM C L K, TSE E Y Y, GANDEK B. Is the standard SF-12 health survey valid and equivalent for a Chinese population? [J]. Qual Life Res, 2005, 14(2): 539-547. DOI: 10.1007/s11136-004-0704-3.
[13] WARE J E J, KOSINSKI M A, KELLER S D. SF-12: how to score the SF-12 physical and mental health summary scales[M]. 2nd ed. Boston, MA: The Health Institute, New England Medical Center, 1995:22-23.
[14] CHARLSON M E, POMPEI P, ALES K L, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation[J]. J Chronic Dis, 1987, 40(5): 373-383. DOI: 10.1016/0021-9681(87)90171-8.
[15] 杨洋.南充市嘉陵区农村老年人医疗服务的利用现状及对策研究[D].雅安: 四川农业大学, 2019:23-24.
[16] FU Y W, LIN W W, YANG Y, et al. Analysis of diverse factors influencing the health status as well as medical and health service utilization in the floating elderly of China[J]. BMC Health Serv Res, 2021, 21(1): 438. DOI: 10.1186/s12913-021-06410-7.
[17] 杨洋,徐慧丹.南充市某县农村老年人医疗服务利用满意度影响因素研究: 基于5镇10村的调研数据[J].乡村科技, 2019(6): 11-13. DOI:10.19345/j.cnki.1674-7909.2019.06.009.
[18] 张丽,童星.农村老年居民住院服务利用及其影响因素研究: 基于CHARLS数据的实证分析[J].南京社会科学, 2014(4): 67-74. DOI: 10.15937/j.cnki.issn1001-8263.2014.04.001.
[19] 陈红敬.人口老龄化背景下农村老年人卫生服务需要及利用研究[D].北京:北京协和医学院, 2012:28.
[20] 丰志鹏.基于安德森行为模型探究慢性病患者卫生服务利用情况及影响因素[D].大连:大连医科大学, 2019:24-26.
[21] WEN X T, CUI L Y, YUAN F, et al. Study on the utilization of inpatient services for middle-aged and elderly rural females in less developed regions of China[J]. Int J Environ Res Public Health, 2020, 17(2): 514. DOI: 10.3390/ijerph17020514.
[22] 董园星.家庭禀赋对老人住院医疗服务利用的影响研究[D].武汉:中南财经政法大学, 2020:40.
[23] KLEIN P W, GEIGER T, CHAVIS N S, et al. The Health Resources and Services Administration's Ryan White HIV/AIDS Program in rural areas of the United States: geographic distribution, provider characteristics, and clinical outcomes[J]. PLoS One, 2020, 15(3): e0230121. DOI: 10.1371/journal.pone.0230121.
[24] 许学华,李晓鹏,李菲,等.老年人主观幸福感的影响因素及感恩的调节作用[J].中国老年学杂志, 2021, 41(17): 3826-3829.
[25] 魏强,苏寒云,吕静,等.家庭规模、社会支持、健康状况对农村老年女性主观幸福感的影响研究[J].西北人口, 2020, 41(5): 106-115. DOI: 10.15884/j.cnki.issn.1007-0672.2020.05.009.
[26] BRZOSKA P, ERDSIEK F, WAURY D. Enabling and predisposing factors for the utilization of preventive dental health care in migrants and non-migrants in Germany[J]. Front Public Health, 2017, 5: 201. DOI: 10.3389/fpubh.2017.00201.
[27] 徐畅.医疗可及性对老年人健康以及医疗服务利用的影响研究[D].北京:首都经济贸易大学, 2019:40-41.
[28] HAJEK A, BRETTSCHNEIDER C, EISELE M, et al. Correlates of hospitalization among the oldest old: results of the AgeCoDe-AgeQualiDe prospective cohort study[J]. Aging Clin Exp Res, 2020, 32(7): 1295-1301. DOI: 10.1007/s40520-019-01315-2.
[29] 赵春艳,余晓英,杨姗姗,等.北京市失能老年人对上门医疗服务利用现状的混合方法学研究[J].中国全科医学, 2021, 24(13): 1676-1683.

河北省农村老年人医疗服务利用及影响因素

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 6

编辑推荐

Metrics

本文评价

[1]	李冬莉,司秋菊,张学茹,沈永青,邸淑珍. 社区安宁疗护服务发展[J]. 医学研究与教育, 2020, 37(2): 70-75.
[2]	王硕，井坤娟. 养老机构老年人需求现状研究[J]. 医学研究与教育, 2015, 32(5): 85-89.
[3]	孙明娟. 社区糖尿病强化管理模式对 2 型糖尿病患者血糖指标的影响[J]. 医学研究与教育, 2014, 31(6): 61-64.
[4]	谢秀君,刘春蕾,王彦. 健康教育对老年公寓冠心病老人生活方式的影响[J]. 医学研究与教育, 2009, 26(6): 71-73.
[5]	曹清清,张春英. 糖尿病社区健康教育的实施[J]. 医学研究与教育, 2009, 26(5): 81-.
[6]	郭彦萍,金晓宁. 实施家属健康宣教对老年全髋置换患者康复的影响[J]. 医学研究与教育, 2009, 26(4): 83-84.