重庆市居民健康服务需求程度及差异化分析

目的 了解居民对健康服务的需求程度，为政府优化健康服务供给政策提供思路借鉴。方法 在重庆市抽取8个区县共1 120名居民进行问卷调查，采用SPSS 22.0软件进行聚类分析、秩和检验和有序多分类logistic回归分析。结果 居民对健康服务的需求程度从强到弱分为5类，需求度最高类型:健康保障服务；需求度较高类型:医院服务、基层医疗卫生服务和专业公共卫生服务；需求度一般类型:社会健康服务、体育健身服务、健康咨询服务和健康保险服务；需求度较弱类型:健康相关零售服务和健康相关租赁服务；需求度最弱类型:健康教育服务。所有不同社会特征的调查对象需求第1位次均为健康保障服务，但第2位次却有所不同:低收入居民对医院服务（OR = 1.225，95%CI:0.820～1.829）和基层医疗卫生服务（OR = 1.556，95%CI:1.042～2.323）的需求较高；初中学历的居民对专业公共卫生服务（OR = 1.639，95%CI:1.039～2.586）的需求较高；60岁以下（OR = 3.438，95%CI:2.059～5.743）、高学历（OR = 0.442，95%CI:0.228～0.858）的居民对体育健身服务的需求较高。结论 健康保障服务是重庆市居民最迫切需要的类型，未来应针对不同人群特征供给差异化健康服务，通过加强居民健康教育和提升健康素养水平来培育多元化健康服务需求。

Analysis of the degree of demand and differentiation of health services among residents in Chongqing

Objective To understand residents’ demand for health services and provide references to optimize the health service supply policy for the government. Methods A questionnaire survey was conducted among 1120 residents in ?8 districts and counties of Chongqing. SPSS 22.0 software was used for cluster analysis, rank sum test and ordered multi-classification Logistic regression analysis. Results The demand of residents for health services could be divided into five categories from strong to weak. The first category was the health care services most needed by residents. The second category was hospital services, grass-roots medical and health services, and professional public health services that were needed relatively. The third category was social health services, physical fitness, health consulting services and health insurance services that were needed generally. The fourth category was health-related retail and health-related rental services with weak demand. The fifth category was the health education service with the weakest demand. Health care services ranked first among the needs of all respondents, but the second place was different. Low-income residents had higher demand for hospital services(OR=1.225, 95%CI:0.820-1.829) and grass-roots medical and health services(OR=1.556, 95%CI:1.042-2.323). Residents with junior high school education had higher demand for professional public health service (OR=1.639, 95%CI:1.039-2.586). Residents under 60 (OR=3.438, 95%CI:2.059-5.743) or highly educated (OR=0.442, 95%CI:0.228-0.858) had higher demand for physical fitness services. Conclusion Healthcare service is the most urgent need of residents in Chongqing. Differentiated health services should be provided according to the characteristics of different groups. Diversified demand for health services should be cultivated by strengthening health education and improving health literacy level of residents.