成都市某区居民健康状况和卫生服务利用调查及影响因素分析

[目的]了解成都某区社区居民健康状况及卫生服务利用情况。[方法]从成都市某区随机选取6个社区的1058户家庭共2850人进行调查。[结果]调查居民两周患病率为4.4%,年龄为两周患病的主要影响因素;慢性病患病率为5.5%,年龄和在业与否是慢性病患病的主要影响因素;居民两周就诊率为40‰,患病后对卫生服务的利用情况总体较好,最常就诊单位为省级及以上医院,其次是市级医院。[结论]社区居民的健康状况较好,对社区卫生服务的利用较差;应加强社区卫生服务工作,满足居民需求。     

上海市徐汇区社区卫生服务需求、利用及影响因素的调查研究

[目的 ]　了解上海市徐汇区居民对社区卫生服务的需求、利用情况以及影响因素。　 [方法 ]　采用多阶段抽样方法 ,对徐汇区辖区内 170 0名居民进行问卷式入户调查。　 [结果 ]　被调查居民的 2周患病率为 11.0 % ,慢性病患病率为 31.8% ,其中 60岁以上老人的患病率 5 9.0 5 % ;在 2周内发病就诊的首选医院是市级医院 ( 39.5 3% ) ,居民对社区卫生服务“较满意”、“很满意”的比例分别为 34 .66%和 30 .0 6%。影响居民对社区卫生服务利用因素的logistic回归分析的结果显示 :年龄、是否就业、居民是否患有慢性病、居民对社区卫生服务的了解程度差异有统计学意义 ;而影响居民对社区卫生服务满意度因素的logistic回归分析的结果显示 :只有“居民对社区卫生服务的了解程度”一项有统计学意义。　[结论 ]　徐汇区的社区卫生服务应该不断加强和完善 ,同时也需要政策和社会的大力支持     

天津市居民卫生服务需要及健康状况分析

目的:通过分析居民两周患病和慢性病患病情况,了解天津市居民的卫生服务需要现状及健康状况,为制定天津市区域卫生规划、优化卫生资源配置提供参考。方法:采用多阶段分层随机抽样方法,对天津市30408名居民的两周患病和慢性病患病情况进行调查;运用统计软件SPSS13.0对数据进行分析。结果:天津市居民整体健康状况有待进一步提高,居民两周患病率为264.34‰;居民慢性病患病率为212.09‰。结论:天津市居民的卫生服务需要量较高,慢性病已经成为影响天津市居民的主要健康问题。     

合肥市社区居民健康状况及其影响因素分析

目的 了解社区居民健康状况及其影响因素,为合理配置社区卫生资源提供决策依据.方法 在合肥市39所CHS中心服务辖区内随机选择40户家庭,采用入户访谈调查全部家庭成员.结果 社区居民2 w患病率为80.0‰;年住院率为7.3%;慢性病患病率为16.4%;15岁及以上居民认为自身健康状况"好"、"一般"及"差"的比例分别为33.6%、58.5%、7.9%;医疗保障制度、文化程度、收入水平及生活行为是影响健康状况的重要因素.结论 在社区居民健康诊断的基础上,合理配置社区卫生资源,精心设计服务提供内容,不断满足社区居民卫生服务需求.     

广州市荔湾区多宝街社区居民卫生服务利用情况调研

目的了解社区居民健康状况、卫生服务需要及利用情况,以及影响居民卫生服务利用的因素,为卫生行政部门制定卫生政策、合理配置卫生资源、提高居民健康水平提供依据及参考。方法通过问卷调查和医学体检两种方式,对荔湾区多宝街社区卫生服务调查数据进行收集及分析,采用集中调查或者入户面访的方法调查。用SPSS 13.0对数据进行统计分析。结果广州市荔湾区多宝街两周患病率为264.4‰,社区卫生服务利用率为54.94%,影响社区卫生服务利用的因素是:性别、年龄、婚姻、慢性病。结论广州市荔湾区多宝街道居民对卫生服务需要量大,但社区卫生服务利用率低,应充分利用社区的资源,发挥社区卫生服务在城市公共卫生服务和基本医疗服务的双重作用。     

南京市社区居民健康和卫生服务利用状况调查

目的了解社区居民健康状况和卫生服务需求。方法采用整群随机抽样法，对南京市12878名居民进行入户调查。结果社区居民慢性病患病率为26．6％，隐性高血压患病率为14．8％，高血压患者药物控制率为35．4％。社区居民的两周患病率、就诊率、年住院率分别为30．8％，13．0％和6．9％。结论应尽快发展社区卫生服务。开展社区慢性病预防。     

济南市社区卫生服务利用情况及影响因素分析

目的 了解城市居民对社区卫生服务利用情况及其影响因素；方法 随机整群抽取了济南市1267名居民进行入户调查；结果 被调查居民慢性病患病率为15.7%，两周患病率为13.1%，两周就诊率为30.7%，两周因病未就诊率为26.6%。影响居民利用这区卫生服务的主要因素是：社区卫生服务人员技术水平低，服务功能不到位，相关的配套政策不健全；结论 应加快社区卫生服务人员的业务素质培训，提高服务质量，完善相关配套政策，是推进社区卫生服务进一步发展急需解决的问题。     

重庆市某社区居民卫生服务需要、需求与利用现状的研究

目的了解重庆市主城区社区居民家庭情况及社区卫生服需求与利用情况,并与第五次国家卫生服务调查结果比较,为合理配置卫生资源、提高居民健康水平及生活质量提供客观依据。方法 2014年5—8月对重庆市巴南区某街道960户家庭采用自行设计的问卷进行入户面对面调查,对社区居民卫生服务需求与利用的相关指标进行统计分析。结果共调查960户家庭、居民2 742人,社区居民两周患病率为9.1%,慢性非传染性疾病(慢性病)患病率为35.6%,两周就诊率为5.9%,两周患者中未就诊比例为35.0%住院率为14.1%,应住院而未住院比例为21.2%;两周患病率、两周就诊率低于第五次国家卫生服务调查结果,慢性病患病率、两周患者未就诊比例、住院率、应住院而未住院比例高于第五次国家卫生服务调查结果;60岁及以上年龄组所占比例大(52.4%),且其两周患病率、慢性病患病率、住院率较高。结论社区居民卫生服务需要总体较大,而对卫生服务的利用率有待提高,社区老龄化程度高,老年人对卫生服务需求和利用相对较高。应加强老年人群医疗资源的供给,优化资源配置,提高社区卫生服务的利用程度与服务质量。     

成都市某社区居民社会支持及健康状况调查研究

目的了解成都市某社区居民社会支持及健康状况,并进行影响因素分析,同时探讨社会支持对居民健康的影响情况,为社区居民的健康促进及社区卫生服务提供重要的依据和建议。方法运用欧洲的五维健康量表(EQ-5D)和社会支持评定量表(SSRS)对1 017名15岁及以上常住居民进行测评,采用描述性分析、统计推断等对社会支持和健康状况影响因素进行分析。结果受访者生命质量得分为(0.84±0.04)分,被调查居民主要健康问题为疼痛/不适,焦虑/抑郁。这两个维度有中度及以上问题的比例分别为8.80%和4.70%;EQVAS评分平均值为(85.75±10.74)分。年龄、性别、就业状况、文化程度等因素对生命质量健康指数的影响,差异无统计学意义;调查对象社会支持得分为(40.34±7.26)分,男性社会支持得分(40.96±7.08)高于女性(39.94±7.35),差异有统计学意义(P<0.05);学生的社会支持得分在各职业中最低(37.00±6.89),职业不同的居民社会支持得分差异具有统计学意义,P<0.05;调查对象慢性病患病率为20.60%,其中离退休居民慢性病患病率最高(40.19%,P<0.05),初中及以下低文化程度居民慢性病患病率(36.40%)高于高中及以上高文化程度者(15.08%),P<0.05。结论关注离退休者、初中及以下人群的健康状况;关注女性和学生社会支持情况。     

城市社区低保人员健康状况及其影响因素分析

目的了解城市低保人员健康状况并分析其影响因素,为制定提高该人群健康状况的措施提供参考。方法采用系统和整群抽样的方法抽取徐州市低保人员445人作为调查对象,并抽取445名非低保人员进行1:1配对,以面对面询问方式进行入户调查。结果低保人员健康自评比非低保人员差,两周患病率和慢性病患病率比非低保人员高(20.4%15.3%,2χ=4.05,P=0.044;56.0%42.4%,2χ=16.18,P=0.0001)。logistic回归分析表明女性(OR=1.54)、非在婚(OR=3.90)、不经常运动(OR=1.81)、患慢性病(OR=4.76)、健康状况比去年变差(OR=4.10)、没有参加社会保险(OR=2.04)是影响低保人员健康的危险因素。结论低保人员健康状况较差,应采取综合性措施提高其健康水平。     

农村低保户家庭青少年心理健康和自尊、心理韧性的现状分析

目的 了解新疆南疆农村低保户家庭不同性别青少年心理健康、自尊、心理韧性的现状和差异,为低保户家庭青少年身心健康发展提供支持。方法 在新疆南疆地区对2 784名农村低保户家庭的青少年进行中学生心理健康量表、自尊量表、心理韧性量表的调查。结果 新疆南疆农村低保户家庭中学生心理健康总分为（2.14±0.67）分;自尊得分为（28.19±4.55）分;心理韧性得分为（54.08±17.79）分。重度心理问题学生占1.01%、中度为10.99%、轻度为43.82%、无心理健康问题为44.18%。结论 新疆南疆农村低保户家庭青少年自尊、心理韧性对心理健康起到直接的保护作用,自尊还可通过心理韧性间接影响青少年心理健康状况。     

Catastrophic household expenditure for health care in a low-income society: a study from Nouna District, Burkina Faso

OBJECTIVE: To quantify the extent of catastrophic household health care expenditure and determine the factors responsible for it in Nouna District, Burkina Faso. METHODS: We used the Nouna Health District Household Survey to collect data on 800 households during 2000-01 for our analysis. The determinants of household catastrophic expenditure were identified by multivariate logistic regression method. FINDINGS: Even at very low levels of health care utilization and modest amount of health expenditure, 6-15% of total households in Nouna District incurred catastrophic health expenditure. The key determinants of catastrophic health expenditure were economic status, household health care utilization especially for modern medical care, illness episodes in an adult household member and presence of a member with chronic illness. CONCLUSION: We conclude that the poorest members of the community incurred catastrophic health expenses. Setting only one threshold/cut-off value to determine catastrophic health expenses may result in inaccurate estimation leading to misinterpretation of important factors. Our findings have important policy implications and can be used to ensure better access to health services and a higher degree of financial protection for low-income groups against the economic impact of illness.     

Contraception and abortion coverage: what do primary care physicians think?

BackgroundInsurance coverage for family planning services has been a highly controversial element of the US health care reform debate. Whether primary care providers (PCPs) support public and private health insurance coverage for family planning services is unknown.Study DesignPCPs in three states were surveyed regarding their opinions on health plan coverage and tax dollar use for contraception and abortion services.ResultsAlmost all PCPs supported health plan coverage for contraception (96%) and use of tax dollars to cover contraception for low-income women (94%). A smaller majority supported health plan coverage for abortions (61%) and use of tax dollars to cover abortions for low-income women (63%). In adjusted models, support of health plan coverage for abortions was associated with female gender and internal medicine specialty, and support of using tax dollars for abortions for low-income women was associated with older age and internal medicine specialty.ConclusionThe majority of PCPs support health insurance coverage of contraception and abortion, as well as tax dollar subsidization of contraception and abortion services for low-income women.     

浙江省农村低保户农民卫生保健状况调查

目的 :了解浙江省农村低保户卫生保健状况及医疗卫生费用。方法 :采用分层整群抽样 ,抽取浙江省开展新型农村合作医疗的试点县和非试点县 343户低保户进行了入户调查。结果 :低保户家庭因病致贫现象严重 ,农民疾病经济负担比较重 ,卫生保健状况令人担忧。结论 :新型农村合作医疗对解决低保户的医疗费用 ,维护其卫生保健有重要意义     

Does non‐profit health insurance reduce financial burden? Evidence from the Vietnam living standards survey panel

Many low-income countries are implementing non-profit medical insurance to increase access to health services, especially among low-income households, and to raise additional revenue for financing public health services. This paper estimates the effect of insurance on out-of-pocket health expenditures using the Vietnam Living Standards Surveys for 1993 and 1998 and appropriate models for panel data. Our findings suggest that health insurance reduces health expenditure when unobserved heterogeneity is accounted for. Failure to capture unobserved heterogeneity produces contrary results that are consistent with previous cross-sectional studies in the literature. Health insurance is found to reduce out-of-pocket expenditure between 16 and 18% and the reduction in expenditure is more pronounced for individuals with lower incomes. At mean income, the effect of health insurance is to reduce health expenditures between 28 and 35%.     

5岁以下儿童医保现状及其影响因素分析:以武汉市硚口区为例

目的:研究武汉市5岁以下儿童医保覆盖情况及其影响因素。方法:分层随机抽取814名5岁以下儿童,利用结构式问卷法收集儿童人口学信息和参保情况。采用描述性分析、卡方检验、多因素Logistic回归法进行统计学分析。结果:武汉市硚口区5岁以下儿童医疗保险覆盖率为66.8%,其参保类型主要是城镇居民医疗保险(57.50%)、新农合(26.50%)及商业保险(24.70%)。儿童的年龄及儿童流动性与儿童是否参保相关(P0.05),而儿童监护人不知道儿童可以参保、儿童户籍、错过参保时间及家庭经济困难是儿童未参保的主要原因。结论:武汉市5岁以下儿童医疗保险覆盖率较低,建议从制度层面消除城乡二元户籍制度,加大对医疗保险政策的宣传力度,帮助低收入家庭儿童参加医疗保险,以促进儿童医保全覆盖。     

Childcare Practices among Construction Workers in Chira Chas,Jharkhand

This study aims at examining the childcare practices and issues experienced by the low-income construction workers in India. It is concerned with understanding varied aspects relating to problems that construction workers, as parents, face while bringing up their children in one of the small construction companies of eastern India, in the state of Jharkhand. Qualitative methods have been used in order to collect the data based upon phenomenological principles. Ethnography and photo-elicitation were used as a primary method of data collection. Apart from this, in-depth interviews were also conducted with the workers of the construction company. Discussion with the participants led to the emergence of four themes: children left alone; playing at risky site areas; poor health of children; and children working along with parents. The research findings indicate that infants are taken by their parents to their place of work whereas children between five and 10 years had to be left alone at home. It was also found that acute poverty was a major cause leading to the consumption of inadequate and low nutritional food, leading to poor health of the children. Based on the study findings, there is an imperative that societal forerunners and philanthropists continue to use research findings to understand the childcare practices amongst the low-income workers and draft strategies accordingly, to improve the situation.     

THE INFLUENCE OF INCOME ON THE EXPERIENCE OF INFORMAL CAREGIVING: POLICY IMPLICATIONS

Examining the need for an eldercare policy is relevant and timely because the population is aging, a focus of care has shifted from institutional to community based, and informal caregivers, primarily women, are increasingly pressured to be responsible for eldercare. The purpose of the study is to examine the differences in the experiences of low-income and those who are not low-income informal caregivers. Three hundred questionnaires were mailed to past and present home care clients and 58 questionnaires were returned (19% response rate). This research revealed that low-income caregivers have increased needs for support and education from those who can afford to pay for their support services. Low-income caregivers experience significantly greater caregiver distress than do caregivers who are not low income. The unique needs of low-income caregivers must be considered in the formation of Canadian eldercare policy as increased health care privatization promotes the growing inequality in health care provision.     

The influence of income on the experience of informal caregiving: policy implications

Examining the need for an eldercare policy is relevant and timely because the population is aging, a focus of care has shifted from institutional to community based, and informal caregivers, primarily women, are increasingly pressured to be responsible for eldercare. The purpose of the study is to examine the differences in the experiences of low-income and those who are not low-income informal caregivers. Three hundred questionnaires were mailed to past and present home care clients and 58 questionnaires were returned (19% response rate). This research revealed that low-income caregivers have increased needs for support and education from those who can afford to pay for their support services. Low-income caregivers experience significantly greater caregiver distress than do caregivers who are not low income. The unique needs of low-income caregivers must be considered in the formation of Canadian eldercare policy as increased health care privatization promotes the growing inequality in health care provision.     

HIV and AIDS relative to other health, social, and relationship concerns among low-income urban women: a brief report

Our objective was to determine the priorities of low-income women regarding health, relationship, and social concerns. Street-intercept surveys were conducted with 161 low-income urban women (mean = 27 years, 85% African American, 80% single mothers) regarding their perceptions of the threat associated with 48 health and social problems. Women rated acquired immune deficiency syndrome (AIDS) as their most important health, social, or relationship concern. Nearly one half of all women indicated that they would attend risk reduction programs to learn how to avoid infection with human immunodeficiency virus (HIV). AIDS is perceived as a serious threat to women's health, and interventions to reduce risk are welcomed.