成都市农转非与城市居民的卫生服务需要与利用分析

目的 了解成都市农转非与城市居民的卫生服务需要与利用情况,为改善居民的健康状况提供政策建议。方法 采用多阶段分层抽样方法抽取该市6188名农转非居民以及3482名城市居民进行问卷调查。结果 成都市的城市居民慢性病患病率(28.3%)稍高于农转非居民(26.1%),但城市与农转非居民的慢性病患病类型前5位排序大体相同。农转非居民的两周患病率(16.1%)、两周就诊率(15.2%)、年住院率(9.7%)分别高于城市居民的两周患病率(12.7%)、两周就诊率(12.2%)、年住院率(6.2%)。农转非居民和城市居民在两周患病后分别有44.7%、41.7%的人去基层医疗机构就诊,在需要住院时分别有50.0%、73.4%的人去三级医院或专科医院就诊。结论 农转非居民的两周患病率更高,城市居民的慢性病患病率更高。农转非和城市居民在两周患病后都更倾向于去基层医疗机构就诊,在住院机构的选择上更倾向于三级医院或专科医院,说明分级诊疗政策的实施在成都取得一定效果。农转非居民的卫生服务利用率高于城市居民,建议政府根据实际情况在新修的农转非社区合理规划医疗机构和分配卫生资源,改善居民健康。

Needs and utilization of health service of urban residents and the residents whose status changed from rural to urban,Chengdu

Objective To understand the needs and utilization of health services of urban residents and the residents whose status changed from rural to urban in Chengdu,and to provide policy suggestions for balancing the distribution of health resources and improving the health of the residents.Methods A questionnaire survey was conducted among 6188 changing residents and 3482 urban residents in the city by multi-stage stratified sampling.Results The prevalence rate of chronic diseases among urban residents(28.3%)was slightly higher than that of the changing residents(26.1%),but the ranking of the top five chronic disease types between the changing residents and urban residents was roughly the same.The two-week prevalence rate(16.1%),two-week visiting rate(15.2%)and annual hospitalization rate(9.7%)of the changing residents were higher than the two-week prevalence rate(12.7%),two-week visiting rate(12.2%)and annual hospitalization rate(6.2%)of urban residents,respectively.After two weeks of illness,44.7% of the changing residents and 41.7% of urban residents went to primary medical institutions,50.0% of the changing residents and 73.4% of urban residents went to tertiary hospitals or specialist hospitals when they needed to be hospitalized.Conclusion The two-week prevalence rate of the changing residents is higher than that of urban residents,but the prevalence of chronic diseases in urban residents is higher than that of changing residents.Both the changing residents and urban residents are more likely to go to primary medical institutions after two weeks of illness,but they prefer tertiary hospitals or specialized hospitals in the choice of hospital institutions,indicating that the implementation of the policy of grading diagnosis and treatment has achieved a certain effect in Chengdu.The utilization rate of health services for the changing residents is higher than that for urban residents.It is recommended that the government should rationally plan medical institutions and allocate health resources to improve the health of residents according to the actual situation in the newly renovated community of the residents whose status changed from rural to urban.