四川省城乡居民就医行为现状及其影响因素分析

目的了解四川省城乡居民就医行为的现状及其影响因素。方法基于2018年四川省卫生服务调查数据描述四川省城乡居民两周内患病就诊及就诊机构选择的基本特征,采用多水平logistic回归分析居民两周内患病是否就诊以及就诊机构选择的影响因素。结果居民两周患病率为41.7%,其中选择就诊的比例为46.4%;影响居民患病后是否就诊以及就诊机构选择的因素主要是居民是否患有慢性病、自感患病伤的严重程度、病伤的持续天数和患者受教育程度(均P<0.05);基本医疗保险类型是就诊机构选择的重要影响因素(P<0.05);居民选择就诊机构并无城乡差异,但少数民族地区的居民选择基层医疗机构就诊的可能性是非少数民族地区居民的2.627倍(P<0.001)。结论四川省居民两周患病后就诊的比例较低,应进一步完善不同类型基本医疗保险制度,提高基层医疗机构服务水平并加强健康教育,合理规范居民就医行为。

Status and influencing factors for health seeking behaviors of rural and urban residents,Sichuan Province

To investigate the status and influencing factors concerning health seeking behaviors of residents in Sichuan. Methods Basic characteristics of clinica visiting and medical institution selection within two weeks for patients in Sichuan were analyzed based on the survey data of the Sixth National Health Service Survey in Sichuan Province. Multilevel logistic models were used to explore the influencing factors regarding two-week visiting and medical institution selection. Results The two-week disease prevalence rate was 41.7%, with 46.4% of which chose to seek treatment. It showed that the chronic diseases status, the self-reported severity of sickness and the duration of illness had both effects on clinical visiting and medical institution selection, especially the type of basic health care insurance for medical institution selection(all P<0.05). There was no difference between rural and urban patients among selection of medical institution, but the probability of selecting primary health care institutions for residents in minority areas was 2.627 times than that of residents in non-minority areas(P<0.001). Conclusion The proportion of patients who sought treatment within two weeks was low in Sichuan. Effective measures should be taken to improve medical insurance system, to promote the service level of primary medical institutions and to strengthen health education.