摘要
目的了解成都市社区慢性阻塞性肺疾病(COPD)患者卫生服务利用情况及其影响因素。方法随机整群抽取成都市6个社区卫生服务试点社区的所有COPD患者作为调查对象,采用逐户走访填写问卷并结合查阅病案的方法对446名患者进行调查,调查内容涉及患者的一般社会人口学特征,疾病相关内容,对待疾病的态度,卫生服务利用信息以及相关卫生费用等。结果成都市社区COPD患者门诊利用率为53.04%,年均门诊次数为6.04±4.05。COPD患者住院就诊率为18.22%,年均住院次数为6.10±2.61,年均住院时间为(51.65±15.91)d。COPD患者对综合性医院和较大的医院的利用率为45.33%,对社区卫生服务中心利用率为18.22%。影响COPD患者门诊就诊的主要因素为年龄、患者种类、对疾病的态度、病情严重程度和医疗负担形式。影响COPD患者住院与否的主要因素有职业、患者种类、病情严重程度、医疗费用负担形式与家人态度。文化水平、收入、职业、对疾病的态度以及医疗费用负担形式则是影响COPD患者到社区卫生服务中心就诊的主要因素。结论成都市社区COPD患者对卫生服务特别是社区卫生服务的利用较低;有较多的因素影响患者对卫生服务的利用。
Objective To investigate the use of health care services by COPD patients and to identify factors that shape the pattern of services utilization. Methods All of the COPD patients who lived in the six randomly selected communities with community health services in 2003 were surveyed. A total of 446 patients completed the interview-administered questionnaires. The medical records of those patients were also reviewed and abstracted if possible. The questions asked in the survey included： social and demographic information, COPD related knowledge and attitudes, use of health care services and medical expenditure associated with the services in the past year. Results About half （53. 04%） of the COPD patients used the outpatient services, with an average visits of 6. 04±4.05 per year. Eighteen percent of the patients had been hospitalized, with an average of 6.10±2. 61 episodes of hospitalizations in one year and an average of length of stay of （51.65±15.91） days. The COPD patients used large comprehensive hospitals （45. 33 %） more often than the community health services （18. 22 % ）. Age, past experiences and attitudes towards COPD, severity of illness and out of pocket payment had significant impact on patients＇ choice of outpatient services. Occupation, past experiences, out of pocket payment, severity of illness and family attitudes had significant impact on patients＇ choice of hospital services. Education, income, occupation, out of pocket payment and attitudes towards COPD had significant impact on patients＇ choice of community health services. Conclusion Underutilization of community health services by COPD patients is obvious in Chengdu. Given the diverse range factors that influence patients＇ choice of services, governmental intervention is needed to encourage the use of community health services.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2007年第2期316-320,共5页
Journal of Sichuan University(Medical Sciences)
