2010年江苏省常州市钟楼区居民社区卫生服务需求与利用分析

目的了解江苏省常州市钟楼区社区居民卫生服务需求与利用情况,为构建适合常州市钟楼社区需要的社区医疗服务模式提供依据。方法采用分层随机整群抽样方法抽取常州市钟楼区全区7个街道常住居民17 838人,用统一的调查表进行问卷调查。结果调查人群的两周患病率为20.1%,两周就诊率为7.1%,多因素Logistic回归分析结果显示,影响社区居民两周就诊率的因素主要是慢性病患病(OR=4.889,95%CI:4.331～5.518),职业(工人OR=0.679,95%CI:0.576～0.800;农民OR=0.710,95%CI:0.536～0.941)以及医保形式(新型农村合作医疗保险OR=0.588,95%CI:0.450～0.769)。居民主要的就诊医院为社区医院和市级医院(分别占46.3%和50.4%)。社区居民最需要的社区卫生服务项目定期体检(49.3%),最希望得到的保健知识主要是常见病的防治知识(58.7%)。结论钟楼社区老年人是社区卫生服务的重点人群;社区居民对社区卫生服务的利用较差,医疗保障和医疗资源利用不均衡,应加强社区卫生服务工作,满足居民需求。

Analysis of the demands and utilizations for community health service among community residents in Zhonglou District of Changzhou in 2010,Jiangsu Province

Objective To understand the demands and utilizations for community health service among community residents in Zhonglou District of Changzhou,and provide evidence for establishing medical service mode which is suitable to Zhonglou Community＇s demand.Methods Using multi-staged stratified random cluster sampling method,17 838 residents in seven streets of Zhonglou District of Changzhou City were investigated with a uniform questionnaire.Results Among the participants,two-week prevalence rate of morbidity was 20.1%,two-week visiting rate was 7.1%.Logistic regression analysis showed that the factors affecting two-week visiting rate of community residents were suffering from chronic diseases（OR=4.889,95%CI：4.331-5.518）,occupation（worker OR=0.679,95%CI：0.576-0.800;peasant OR=0.710,95%CI：0.536-0.941）,and form of health insurance（New Rural Cooperative Medical System OR=0.588,95%CI：0.450-0.769）.The main visited hospitals were community hospitals and municipal hospitals（accounting for 46.3% and 50.4%,respectively）.The most desirable services for community residents was regular medical examinations（49.3%）,the most desirable health care knowledge was knowledge of the prevention and treatment of common diseases（58.7%）.Conclusion The elderly population is the key population of community health service in Zhonglou community.The community health service utilization of community residents is poor,medical care and the utilization of medical resources are not equilibrium.It is necessary to strengthen community health services for meeting residents＇ demands.