山东省城市社区患病老年人就医时机及影响因素

目的 了解城市社区老年人就医时机及影响因素。方法 于2014年10月,采用分层随机抽样方法,抽取山东省3个市≥60岁905例患病老年人进行问卷调查。结果 在调查前1年内患病且发生就医行为的905例老年人中,立即就医者占83.4%,疼痛难忍时就医者占9.1%,一直拖着不就医者占7.5%;不同家庭人口规模、家庭年医疗支出、有无健康档案和到最近医疗机构时间的老年人就医时机比较,差异均有统计学意义(χ²=14.235、18.848、14.443、20.225,均P<0.05);有序多分类logistic回归分析结果显示,家庭年医疗支出(OR=0.401、0.531)、有无健康档案(OR=0.421)和到最近医疗机构的时间(OR=0.429、0.614)是城市社区老年人就医时机选择的影响因素(P<0.05)。结论 城市社区老年人就医时机较为合理,家庭年医疗支出、有无健康档案和到最近医疗机构的时间对就医时机选择有影响。

Timing of visiting a doctor after being ill and its influencing factors among urban community elders in Shandong province

Objective To study the timing of visiting a doctor after being ill and its influencing factors among urban elderly residents.Methods Stratified random sampling method was used and 905 permanent residents aged 60 years or older and having the history of seeking medical service during previous one year were selected from 3 cities in Shandong province for a face-to-face questionnaire survey in October 2014.Results Most of the participants(84.3%) reported visiting a doctor immediately when having a self-perceived illness;9.1% reported seeking medical service only when having a severe pain or illness;and 7.5% did not seek any medical service even having a self-perceived illness for a long time.The participants' timing of visiting a doctor differed significantly by family size,annual familial medical expenditure,whether having health record established by a medical institution,and the time required from home to the nearest medical institution(all P<0.05). The results of order multivariate logistic regression showed that annual familial medical expenditure(odds ratio[OR]=0.401 and 0.531 for the expenditure of <5 000 and 2 000-5 000 compared to that of >5 000 RMB yuan),with health record established by a medical institution(OR=0.421),and the time to the nearest medical institution(OR=0.429 and 0.614 for <5 and 5-10 compared to >10 minutes) were factors influencing the timing of visiting a doctor among the participants(P<0.05 for all).Conclusion The timing of visiting a doctor after being ill is generally right and influenced mainly by annual familial medical expenditure,whether having a health record established by a medical institution,and the time required from home to the nearest medical institution among elderly urban residents in Shandong province.