中西部农村慢性病老年人住院服务利用及其影响因素分析——基于多水平模型的宁夏四县为例

目的 了解中西部农村患有慢性病的老年人住院服务利用状况，并探讨其影响因素，为政府进一步落实卫生政策和提高农村慢性病老年人卫生服务质量提供参考依据。方法 采用多阶段整群随机抽样方法，对宁夏4个县的2 450名慢性病老年人进行调查，使用χ²检验分析不同慢性病老年人住院率的差异，运用多水平模型分析慢性病老年人住院率的影响因素。结果 中西部农村地区慢性病老年人住院为37.8%(926/2 450)。多水平模型结果显示，女性较男性有0.702(0.582～0.846)倍的风险住院，65～69岁的人较60～64岁的人有0.748(0.583～0.960)倍的风险住院，≥70岁的人较60～64岁的人有0.616(0.482～0.788)倍的风险住院，非务农的人较务农的人有0.782(0.642～0.953)倍的风险住院，中高收入组的人较低收入组的人有0.603(0.448～0.812)倍的风险住院，高收入组的人较低收入组的人有0.562(0.415～0.761)倍的风险住院。结论 宁夏农村慢性病老年人住院服务利用较高，但受到性别、年龄、职业和家庭年人均收入等多方面因素的影响，应...

Analysis on the utilization of hospitalization services for the elderly with chronic diseases in rural areas of central and western China and its influencing factors: a case study of four counties in Ningxia based on multi-level model

Objective To understand the utilization of inpatient services for the elderly with chronic diseases in rural areas of central and western China, and explore its influencing factors, to provide reference for the government to further implement health policies and improve the quality of health services. Methods Multi-stage cluster random sampling method was used to select 2 450 elderly people with chronic diseases in four counties of Ningxia. The difference of hospitalization rate of elderly people with different chronic diseases was analyzed by χ2 test, and the influencing factors of hospitalization rate of elderly people with chronic diseases were analyzed by multi-level model. Results There were 37.8% (926/2 450) of the elderly with chronic diseases hospitalized in rural areas of central and western China. The results of multi-level model showed that the risk of hospitalization was 0.702 (0.582-0.846) for women compared with men, 0.748 (0.583-0.960) for people aged 65 to 69 years compared with those aged 60 to 64 years, 0.616 (0.482-0.788) for people aged ≥70 years compared with those aged 60 to 64 years, 0.782(0.642-0.953) for non-farmers compared with farmers, 0.603 (0.448-0.812) for middle and high-income group compared with low income group, and 0.562 (0.415-0.761) for high-income group compared with low income group. Conclusion The utilization of hospitalization services for the elderly with chronic diseases in rural areas of Ningxia is relatively high, but it is affected by many factors, such as gender, age, occupation, and annual per capita income of the family. We should pay attention to the health of the elderly with chronic diseases, optimize the local medical and health service system, and allocate health resources rationally to maximize the utilization of health services.