湖北省流动人口基本公共卫生服务利用现状及影响因素

目的了解湖北省流动人口基本公共卫生服务利用情况,并分析其影响因素。方法利用2017年湖北省流动人口卫生计生动态监测数据,采用单因素分析和二分类logistic回归模型进行统计分析。结果在流入湖北省的5 000名被调查流动人口中,2周患病率为6.2%,建档率为46.0%,81.9%的流动人口接受过健康教育,35岁及以上患有慢性病的流动人口中49.1%接受过慢性病管理服务。与非农业户口的流动人口相比,农业户口流动人口建档率较高(OR=1.218,95%CI:1.023～1.450);与行业为建筑业的流动人口相比,制造业、批发零售业、住宿餐饮业、社会服务业、交通运输业以及其他行业的流动人口建档率较高(OR=1.053,95%CI:0.778～1.425;OR=1.413,95%CI:1.066～1.873;OR=1.502,95%CI:1.106～2.041;OR=1.621,95%CI:1.199～2.190;OR=1.418,95%CI:0.934～2.151;OR=1.635,95%CI:1.189～2.249);与就医距离>30 min的流动人口相比,就医距离≤15min、>15～30 min的流动人口建档率较高(OR=2.373,95%CI:0.925～6.085;OR=1.843,95%CI:0.707～4.804);与流动范围为跨省的流动人口相比,省内跨市的流动人口建档率较低(OR=0.951,95%CI:0.811～1.117),市内跨县的流动人口建档率较高(OR=1.261,95%CI:1.070～1.485);与自评不健康的流动人口相比,自评健康和基本健康的流动人口建档率较高(OR=1.783,95%CI:1.123～2.831;OR=1.264,95%CI:0.783～2.039)。结论湖北省流动人口基本公共卫生服务利用不均衡,不同户籍、不同行业、不同就医距离、不同流动范围会影响流动人口对基本公共卫生服务利用的情况,需关注重点人群,提供有针对性的基本公共卫生服务。

Current status and influencing factors of basic public health service utilization among migrant population in Hubei Province

Objective]To investigate the status of basic public health service utilization among migrant population in Hubei Province,and analyze its influencing factors.Methods]The dynamic monitoring data of health and family planning among migrants in Hubei Province in 2017 were used. Univariate analysis and binary logistic regression model were adopted for statistical analysis.Results]Among 5 000 migrants who were investigated and lived in Hubei province,the two-week prevalence rate was 6.2%,and the rate of health record establishment was 46.0%,and 81.9% of migrants received the health education. Among the migrants with chronic disease who were 35 years old or elder,49.6% received chronic disease management service. Compared with migrants with non-agriculture registered permanent residence,the rate of health record establishment of migrants with agriculture registered permanent residence was higher(OR=1.218,95% CI: 1.023-1.450). Compared with migrants worked in construction industry,the rates of health record establishment of migrants who worked in the manufacturing industry,wholesale and retail trade,hotel and catering industry,social service industry,transportation industry,or other industry were higher(OR=1.053,95% CI:0.778-1.425;OR=1.413,95% CI:1.066-1.873;OR=1.502,95% CI:1.106-2.041;OR=1.621,95% CI:1.199-2.190;OR=1.418,95% CI:0.934-2.151;OR =1.635,95% CI:1.189-2.249). Compared with migrants who took >30 minutes to medical institutions,the rates of health record establishment of migrants who took ≤15 minutes or 15-30 minutes were higher(OR=2.373,95% CI:0.925-6.085;OR=1.843,95%CI:0.707-4.804). Compared with migrants who migrated among different provinces,the rate of health record establishment of migrants who migrated among different cities was lower(OR=0.951,95% CI:0.811-1.117),and the rate of health record establishment of migrants who migrated among different counties was higher(OR=1.261,95%CI: 1.070-1.485). Compared with migrants who reported poor self-rated health,the rates of health record establishment of migrants who reported good or general self-rated health were higher(OR=1.783,95% CI: 1.123-2.831;OR=1.264,95% CI:0.783-2.039).Conclusion]For the migrants in Hubei province,the utilization of basic public health services is unequal. Different registered permanent residence,industries,distance to medical institutions,and migration scopes will influence the utilization of basic public health services among migrants. We need to fo-cus on key population and provide targeted basic public health service.