慢性病趋势预测瓶颈剖析及优化模式构建分析

  目的  了解中国慢性病患者门诊服务利用现状及其影响因素，为提高慢性病患者对门诊服务的利用率提供参考依据。  方法  于2018年10月 — 2019年3月采用方便抽样与滚雪球抽样相结合的方法在山东省、江苏省、天津市、贵州省、广西省、黑龙江省和山西省抽取1 036例慢性病患者进行问卷调查，构建Anderson模型分析东部、中部和西部3个地区慢性病患者门诊服务利用的影响因素。  结果  中国慢性病患者两周内门诊服务利用率为37.36 %。多因素非条件logistic回归分析结果显示，贫困户、有兄弟姐妹和患慢性病数量 ≥ 2种的中国慢性病患者门诊服务利用率较高，西部地区、体力劳动者、年人均收入 ≥ 5 000元和新农合医保的中国慢性病患者门诊服务利用率较低；使能资源因素对慢性病患者门诊服务利用率影响最大，倾向特征和需求因素对慢性病患者门诊服务利用率也有一定影响。  结论  中国慢性病患者两周内门诊服务利用率较低，地区、职业类型、年人均收入、是否为贫困户、医保类型、有无兄弟姐妹和患慢性病数量是中国慢性病患者门诊服务利用的主要影响因素。

Predictors of service utilization among youth diagnosed with mood disorders

  Objective  To examine the status quo and influencing factors of outpatient service utilization among chronic disease patients in China and to provide evidences for promoting the utilization of outpatient services in the patients.  Methods  Using convenient and snowball sampling, we recruited 1 059 chronic disease patients (hypertension, diabetes, cardiovascular diseases and malignant tumor) in 7 provincial level regions in eastern, central and western China and conducted an online self-administered questionnaire survey between October 2018 and March 2019. Anderson model was adopted to analyze influencing factors of outpatient service utilization among the patients.  Results  The two-weeks rate of outpatient service utilization was 37.36% among the 1 036 patients with valid response. Unconditional multivariate logistic regression analysis demonstrated that the respondents with poor household economic condition, having siblings, and suffering from two or more chronic diseases were more likely to utilize outpatient medical service; while, those living in western regions, being manual workers, with average annual income of 5 000 yuan RMB per capita, and participating in the New Rural Cooperative Medical Scheme were less likely to utilize outpatient medical service. Enabling resources (including income per capita, household economic status, type of medical insurance and number of siblings) were the most significant impact factors for the utilization of outpatient service among the respondents, followed by demographic indicators and number of chronic diseases suffered from.  Conclusion  The two-weeks rate of outpatient service utilization is low and mainly influenced by living region, occupation, average annual income per capita, family economic status, type of medical insurance, number of siblings and number of chronic diseases suffered from among chronic disease patients in China.