宁夏农村7岁以下儿童门诊和住院卫生服务利用影响因素对比研究

目的 通过对儿童卫生服务利用情况的分析，进一步对比研究宁夏农村7岁以下儿童门诊和住院卫生服务利用的影响因素及其差异。方法 采用多阶段分层随机抽样的方法于2009年、2012年、2015年、2019年在宁夏西吉、海原、盐池、彭阳四县随机抽取10 600名7岁以下儿童进行卫生服务调查。结果 单因素分析发现，离家最近的医疗机构距离、家庭收入水平不同的儿童门诊和住院卫生服务利用不同，差异均具有统计学意义（〖XC五号.EPS;P〗值分别为4.792，32.346，25.518，10.965，P值均＜0.05）；多因素logistic回归分析发现年龄、家庭收入水平是儿童门诊和住院卫生服务利用的共同影响因素，年龄越小，家庭收入水平越低，儿童门诊和住院卫生服务利用越高；其中性别（ P= 0.001 ，OR= 0.700 ，95%CI :0.585~0.837）、离家最近的医疗机构距离（ P= 0.039 ，OR= 1.247 ，95%CI :1.011~1.538）也是儿童住院卫生服务利用的影响因素。结论 卫生服务地理可及性和家庭收入水平是宁夏农村地区儿童卫生服务利用的主要影响因素，政府应继续关注当地儿童卫生保健服务，适时调整相关政策，满足儿童卫生服务需求。

A comparative study of factors influencing the utilization of outpatient and inpatient health services for children under 7 years old in rural Ningxia

Objective To further compare and study the influencing factors and differences of outpatient and inpatient health service utilization of children under 7 years old in rural Ningxia. Methods Using stratified sampling strategy, 10 600 children under 7 years old were randomly selected from Xiji, Haiyuan, Yanchi and Pengyang counties of Ningxia Autonomous Region in 2009, 2012, 2015 and 2019. Results Univariate analysis showed that differences in the distance from the nearest medical institution to home and family income levels were statistically significant (x² were 4.792, 32.346, 25.518 and 10.965, P<0.05). Multivariate logistic regression analysis showed that age and family income level were common influencing factors of children’s outpatient and inpatient health service utilization. The younger the age, the lower the family income level, the higher the utilization of children’s outpatient and inpatient health service. Among them, gender (P=0.001, OR=0.700, 95%CI: 0.585-0.837) and the distance from the nearest medical institution to home (P=0.039, OR=1.247, 95%CI: 1.011-1.538) were also the influencing factors of children’s inpatient health service utilization. Conclusion The geographical accessibility of health services and family income level are the main influencing factors for the utilization of children’s health services in rural areas of Ningxia. The government should continue paying attention to local children’s health care services and adjust relevant policies in time to meet the needs of children’s health services.