四川省地震后极重灾区与一般灾区居民两周患病率和慢性病患病率及其影响因素分析

发布时间：2018-06-10 00:31

本文选题：地震 + 卫生服务需求　；参考：《中国全科医学》2017年27期

【摘要】：目的了解四川省地震后极重灾区、一般灾区居民两周患病率和慢性病患病率情况,并分析其影响因素,以期为政府制定卫生政策提供理论依据。方法 2016年10—12月以受灾程度为分层因素,对极重灾区(汶川县、安县、什邡市、茂县)、一般灾区[南充市辖三区(顺庆区、高坪区、嘉陵区)、广安市广安区、遂宁市安居区]的常住居民(年龄45岁)进行问卷调查,其中极重灾区、一般灾区分别纳入调查对象600例、550例。采用自行设计的《居民卫生服务需求和利用状况调查问卷》进行自填问卷为主、当面访问为辅的问卷调查,问卷内容主要包括居民的一般资料、卫生服务需求情况(两周患病情况、慢性病患病情况及自评健康状况),并分析极重灾区、一般灾区居民两周患病情况、慢性病患病情况的影响因素。结果极重灾区共发放问卷600份,回收问卷532份,问卷回收率88.7%;其中有效问卷521份,有效回收率86.8%。一般灾区共发放问卷550份,回收问卷550份,问卷回收率100.0%;有效问卷516份,有效回收率93.8%。极重灾区居民两周患病率、慢性病患病率分别为41.8%、26.5%,一般灾区居民两周患病率、慢性病患病率分别为27.3%、37.2%。极重灾区居民两周患病率高于一般灾区,慢性病患病率低于一般灾区(χ~2值分别为22.992、11.677,P值分别为0.001、0.009)。多因素Logistic回归分析结果显示,养老保险类型(城镇居民养老保险)、自评健康状况是极重灾区居民两周患病率的影响因素(P0.05);职业(事业单位人员、企业员工)、自评健康状况(较差、很差)是一般灾区居民两周患病率的影响因素(P0.05);自评健康状况(一般、较差、很差)是极重灾区居民慢性病患病情况的影响因素(P0.05);文化程度(小学及以下)、职业(事业单位人员)是一般灾区居民慢性病患病情况的影响因素(P0.05)。结论四川省地震后极重灾区、一般灾区居民两周患病率、慢性病患病率均处于较高水平。同时极重灾区、一般灾区居民两周患病率的影响因素分别为养老保险类型、自评健康状况,职业、自评健康状况;极重灾区、一般灾区居民慢性病患病率的影响因素分别为自评健康状况,文化程度、职业。因此应明确重点人群的卫生服务需求,加强健康管理,稳步控制两类地区居民患病率。
[Abstract]:Objective to investigate the prevalence rate of two weeks and chronic diseases among the residents in the disaster areas after the earthquake in Sichuan Province, and to analyze the influencing factors so as to provide theoretical basis for the government to formulate health policies. Methods from October to December 2016, the disaster level was taken as a stratified factor, and the disaster areas (Wenchuan County, an County, Shifang City, Maoxian County) and the general disaster area [Nanchong City] were divided into three districts (Shunqing District, Gaoping District, Jialing District, Guang'an District, Guang'an District). A questionnaire survey was carried out among the residents (aged 45 years) in the Anju District of Suining City. Among them, there were 600 or 550 cases in the disaster area, which were included respectively in the general disaster area. Using the self-designed questionnaire on the demand and Utilization of residents' Health Services, the questionnaire was mainly self-filled, supplemented by in-person interviews. The contents of the questionnaire mainly included the general information of the residents. Health service demand (2 weeks prevalence, chronic disease and self-assessment of health status) and analysis of the extremely hard disaster area, the general disaster area residents two weeks disease situation, chronic disease prevalence factors. Results A total of 600 questionnaires were sent out, 532 questionnaires were collected, and the recovery rate was 88.70.Among them, 521 were valid questionnaires, and the effective recovery rate was 86.80.Results A total of 550 questionnaires were sent out, 550 questionnaires were collected, and the rate of recovery was 100.00.The effective questionnaires were 516, and the effective rate was 93.88. The prevalence rate of chronic diseases was 41.8% 26.5. the prevalence rate of general residents in the disaster area was 27.3% 37.2%, respectively. The two-week prevalence rate was higher and the prevalence rate of chronic diseases was lower than that in the general disaster areas (蠂 ~ 2 = 22.992n 11.677g P = 0.001). The results of multivariate logistic regression analysis showed that the type of pension insurance (urban residents' old-age insurance, self-assessment of health status is the most serious disaster area residents' two-week prevalence rate is P0.05N), occupation (public institution personnel), Self-assessment of health status (poor, very poor) is the influence factor of two-week prevalence rate of the general disaster area residents (P0.05%), self-assessment of health status (average, poor) is a factor of affecting the general disaster area residents' two-week prevalence rate (average, poor, poor). Poor) is the influencing factor of the chronic disease condition of the residents in the most serious disaster area, and the educational level (primary school and below), occupation (the personnel of the institution) is the influencing factor of the chronic disease condition of the residents in the disaster area in general. Conclusion the prevalence rate of two weeks and chronic diseases of the residents in the disaster area after the earthquake in Sichuan Province are all at a high level. At the same time, the influencing factors of the two-week prevalence rate of the residents in the worst-hit areas and the general disaster areas were the types of old-age insurance, self-assessment of health status, occupation and self-assessment of health status. The influencing factors of chronic disease prevalence were self-rated health status, education level and occupation. Therefore, the health service needs of the key population should be defined, health management should be strengthened, and the prevalence rate of residents in the two areas should be controlled steadily.
【作者单位】：川北医学院管理学院;乐至县中医医院;
【基金】：四川省基层卫生事业发展研究中心课题(SWFZ15-Y-24)——分级诊疗制度下基层医疗卫生服务需求与利用研究四川省软科学项目(2013ZR0088)——地震后中远期社会支持网络对灾民卫生服务利用行为的影响研究
【分类号】：R129

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