山东省老年人卫生服务利用研究

发布时间：2018-01-31 19:38

本文关键词： 山东省老年人卫生服务利用现况分析　出处：《山东大学》2016年硕士论文　论文类型：学位论文

【摘要】：1.研究背景随着经济的发展和医疗水平的进步,人口老龄化已经成为全球范围内的重大社会问题。2000年第五次全国人口普查数据显示,山东省65岁及以上的人口占8.03%,标志着山东省进入老龄化社会。而第六次全国人口普查数据显示,山东省65岁及以上的人口占9.84%,同比上升了1.81个百分点。老年人口的快速增长,给山东省医疗卫生系统带来了沉重的负担。因此,在人口老龄化背景下针对老年人卫生服务利用方面的研究,既是对老龄化研究的一个补充,同时也对我国医疗卫生事业的发展具有重要意义。2.研究目的本研究的总目的是研究山东省老年人的卫生服务利用情况,探索人口老龄化背景下影响老年人卫生服务利用的因素,为改善山东省老年人卫生服务利用提供政策依据。具体分目标包括：了解山东省老年人的基本情况及健康状况；了解山东省老年人的卫生服务需要、利用及满意度情况,并分析其影响因素；为改善山东省老年人卫生服务利用提供政策建议。3.资料来源与方法数据来源于2013年第五次国家卫生服务调查中的山东省数据,采用多阶段分层整群随机抽样的方法进行抽取,全省共抽取12010户(共33070人),其中60岁以上的老年人7941人。采用《家庭健康询问调查表》对老年人的基本情况、健康状况及卫生服务现状进行面对面问卷调查。研究利用描述性统计、单因素卡方检验以及多因素Logistic回归分析山东省老年人的卫生服务需要、利用及满意度情况,探索老年人卫生服务利用的影响因素。4.主要结果被调查的老年人两周患病率49.2%,两周就诊率为12.0%,两周未就诊率17.8%。未就诊的最主要原因是自感病轻。老年人年住院率14.9%,未住院率18.9%。需要住院而未住院的最主要原因是经济困难。山东省老年人慢性病患病率58.8%,老年人慢性病患病率最高的前三位依次是高血压、牙周炎和糖尿病。单因素卡方检验结果显示,影响山东省老年人两周就诊率的因素有地区、年龄、文化程度、就业状况、医疗保险类型、平均每周体育锻炼次数、医疗机构的距离和慢性病患病情况(P0.05),影响山东省老年人年住院率的因素有性别、年龄、就业状况、医疗保险类型、家庭年收入、收入来源、吸烟状况、饮酒状况、健康体检、慢性病患病情况(P0.05)。多因素Logistic回归分析结果显示,地区、医疗保险类型和慢性病患病情况是影响老年人两周就诊的主要因素,农村地区老年人两周就诊率高于城市,城镇职工基本医疗保险和新农合老年人两周就诊率最高,患慢性病的老年人高于不患病的老年人。性别、就业状况、医疗保险类型、家庭年总收入、吸烟、饮酒、健康体检和慢性病患病情况是影响老年人年住院率的主要因素,男性老年人年住院率高于女性,离退休和失业、无业的老年人高于在业的老年人,有医疗保险的老年人住院率高于没有保险的老年人,高收入家庭高于低收入家庭,吸烟、饮酒、健康体检等生活方式对卫生服务利用有影响,慢性病患者高于非慢性病患者。5.结论与建议山东省老年人卫生服务需要量大,利用率不高,卫生服务可及性较好,卫生服务质量有待改善。应多措并举加强针对老年人的健康教育；提高老年人的医保报销比例；加强基层医疗卫生机构的服务质量；加强针对老年人慢性病的预防与治疗；加快推进“医养结合”养老模式,实现健康老龄化。
[Abstract]:1. research background with the development of economy and the progress of medical technology, population aging has become a major social problem of.2000 worldwide in the fifth national census data show that Shandong province's population aged 65 and over accounted for 8.03%, marking the Shandong province entered the aging society. The sixth national census data show, Shandong 65 years old and above accounted for 9.84% of the population, an increase of 1.81 percentage points. The rapid growth of the elderly population has brought a heavy burden to the health care system in Shandong province. Therefore, the aging of the population in the background of the research of health care utilization years old, is a supplement of the Study on aging. At the same time the development of China's medical and health undertakings has important significance to study.2. the general purpose of this study is to use the case study of the elderly in Shandong Province health services, explore the aging of population Factors affecting the utilization of health service for the elderly in the background, in order to provide policy basis for improving the utilization of health service for the elderly in Shandong province. The specific objectives include: to understand the basic situation of the elderly in Shandong province and the health status of the elderly in Shandong province; to understand the health service demand, utilization and satisfaction, and analyze the influencing factors for improvement; Shandong Province health service for the elderly to provide policy recommendations for.3. data sources and methods of data from the 2013 Fifth National Health Services Survey in Shandong Province, using the method of multi stage stratified random sampling were selected, the province's total of 12010 households were selected (33070 people), of which 60 people over the age of 7941 the family health inquiry questionnaires. < > the basic situation of the elderly, health status and health service of face-to-face questionnaire survey. Based on descriptive statistics, single The factors of chi square test and Logistic regression analysis of the elderly in Shandong Province health service need, utilization and satisfaction, to explore the.4. factors affecting the elderly health service utilization of the main results of the older two week prevalence rate of 49.2%, two week visiting rate was 12%, the main reason for not visiting the two attendance rate of 17.8%. the weekend is a mild illness. The rate of hospitalized elderly patients 14.9% years, the main reason for non hospitalization rate 18.9%. need hospitalization is economic difficulties. The prevalence rate was 58.8% in Shandong Province, chronic diseases in the elderly, the elderly chronic disease prevalence rate was the highest in the top three were hypertension, diabetes and periodontitis. Single factor chi square test the results showed that the influence factors of elderly in Shandong province two week visiting rate are area, age, educational level, employment status, health insurance type, average weekly frequency of physical exercise, medical institutions and the slow distance The prevalence of sexually transmitted diseases (P0.05), affecting the elderly in Shandong Province, the hospitalization rate of the factors of sex, age, employment status, medical insurance type, family income, income, smoking status, drinking status, physical examination, prevalence of chronic disease (P0.05). Multivariate Logistic regression analysis showed that the area of medical. The type of insurance and the prevalence of chronic diseases are the main factors affecting the elderly two weeks of treatment, the elderly in rural areas two week visiting rate is higher than the city, the basic medical insurance for urban workers and farmers aged two week visiting rate, suffering from chronic disease in the elderly is higher than the prevalence of the elderly. Gender, employment status, medical the type of insurance, the total family income, smoking, drinking, health examination and the prevalence of chronic diseases is the main factors affecting the elderly hospitalization rate was higher than that of female, male hospitalized elderly, retired and unemployed, unemployed The elderly is higher than that in the industry of the elderly, the elderly have medical insurance hospitalization rate is higher than the uninsured elderly, high income families are higher than the low income family, smoking, drinking, healthy life style have influence on health service utilization, patients with chronic disease than non.5. patients with chronic diseases in Shandong Province, the conclusion and suggestion in elderly people health service demand, utilization rate is not high, health services and better health service quality needs to be improved. We should take measures to strengthen the health education for the elderly; improve the elderly medical insurance reimbursement; strengthen basic medical and health service quality; strengthen the prevention and treatment of chronic diseases for the elderly; accelerate the medical raising combined with the pension mode, to achieve healthy aging.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R197.1

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