上海流动老人卫生服务利用情况

目的 了解上海流动老人卫生服务利用情况，探索其影响因素，为提高流动老人卫生服务利用水平，保障其健康提供科学依据。 方法 利用2015年国家卫计委流动人口卫生计生动态监测调查中上海流动老人相关数据进行χ2检验等统计分析。 结果 调查涉及的752名流动老人，参保率为85.7%，主要参保地为户籍地；平常生小病就医率为56.8%(427人)，自行买药占39.5%(297人)；174名经医生确诊的高血压／糖尿病流动老人患者中接受过社区随访的仅占29.9%(52人)。流动老人住院率为4.0%(30人)，经医生诊断需住院的有40人，实际住院人数为30人，应住院未住院患者中主要原因为本人／家人觉得没有必要占60.0%(6人)，无人回答因经济困难未住院。卫生服务利用率在流动原因为养老者中最高，因为照顾子女者中最低；参加过社区健康体检者卫生服务利用率比未参加过者高；是否参加社会医疗保险对其卫生服务利用率没有影响，但是参加居民医保者其利用率显著高于参加其他类型医保者。 结论 流动老人卫生服务利用率明显较低，是基本公共卫生服务例如慢性病社区管理的覆盖盲区，社会医疗保险没有起到应有的保障作用，应该制定出适宜流动老人的基本公共卫生服务等相关政策与措施，同时提高流动老人的健康素养等，从而提高其对卫生服务的利用率。 

Survey on utilization of health service among old floating population in Shanghai

Objective To investigate the utilization of health service among old floating population in Shanghai and explore the influencing factors,provide a scientific basis for improving their level of utilization of health services. Methods The data of 2015 National Dynamic Floating Population Monitoring Survey was used to analyze the utilization of health service among old floating population in Shanghai.Chi-square test was used to the statistical analysis. Results Total 752 old floating people were enrolled.The insurance rate among the old floating population was 85.7%,most of them took part in the insurance in their hometown.The rate to go to a doctor when sick was 56.8%(427 persons),the rate of 174 high blood pressure/diabetes patients who had received community follow-up was 29.9%(52 persons).The rate of hospitalization was 4.0%(30 persons),40 old person had been diagnosed need be hospitalized,but only 30 persons who did it,the main reason for who should be hospitalized but not was family/self-feel no need,the rate was 60.0%(6 persons).The utilization of health service rate was highest in those who floating for pension and lowest in those for work,also higher in those who had took part in community health examination than those without community health examination.Whether had basic medical insurance had no effect on health services utilization,but those who participated in residents medical insurance was significantly higher than those had other types of health insurance. Conclusion The utilization of health service among old floating population in Shanghai is quite low,they are the blind area of basic public health services such as chronic disease community management,basic social insurance does not play its due role in safeguarding.We should work out better policies and measures suitable for the special population in the area of medical especially basic public health services,as well as improve their health literacy to improve their health services utilization rate.