四川省农村居民就医行为及影响因素研究

目的　分析四川省农村居民就医行为现状，并基于安德森卫生服务利用模型探索四川省农村居民就医行为影响因素。方法　 于2019年7月在四川省Z市采用多阶段随机抽样的方法抽取调查对象进行入户面对面访谈。运用多水平统计模型分析四川省农村居民就医行为的影响因素。结果　四川省农村居民患病后就医比例为58.42%。倾向因素中，年龄≥75岁（OR = 3.732，95%CI:1.303～10.692）的农村居民患病后就医比例更高；促进资源中，家庭经济情况高水平（OR = 2.206，95%CI:1.211～4.018）会促进农村居民就医，到达最近医疗机构时间＜20 min（OR = 0.540，95%CI:0.316～0.922）和≥30 min （OR = 0.418，95%CI:0.213～0.818）会阻碍其就医；需要因素中，自评疾病严重程度为严重（OR = 4.651，95%CI:2.568～8.422）的农村居民患病后就医比例更高。结论　四川省农村居民患病后就医行为发生率低。倾向因素、促进资源、需要因素都对四川省农村居民的就医行为有重要影响，且倾向因素和需要因素影响更为显著。

Research on health service seeking behavior and its influencing factors of rural residents in Sichuan Province

To analyze the health seeking behavior of rural residents in Sichuan Province and explore the influencing factors based on the Anderson health service utilization model. Methods In July 2019, multi-stage random sampling was used to select rural residents in Z prefecture, Sichuan Province for face-to-face interview. Multilevel model was used to analyze the influencing factors. Results The proportion of health seeking behavior of rural residents in Sichuan Province was 58.42%. Among the predisposing factors, higher proportion of health seeking behavior was verified among the ill rural residents aged 75 years or older(OR=3.732, 95%CI: 1.303-10.692). Among enabling factors, a high level of family economic status(OR=2.206, 95%CI: 1.211-4.018) promoted health service seeking behavior of rural residents, and arriving at the nearest medical facility for less than 20 minutes(OR=0.540, 95%CI: 0.316-0.922) and for more than 30 minutes(OR=0.418, 95% CI: 0.213-0.818) impeded their access to health care. Among need factors, rural residents with severe self-reported disease severity(OR=4.651, 95%CI: 2.568-8.422) had a higher proportion of health seeking behavior after illness.Conclusion The rate of health service seeking behavior after illness among rural residents in Sichuan Province is low. Three factors all have important influence on the health service seeking behavior of rural residents in Sichuan Province, while predisposing factors and need factors are more notable.