上海市长宁区65岁及以上老年居民卫生服务调查

Investigation of the Health Service for Elderly Residents over 65 Years Old in Changning District,Shanghai

中文关键词: 老年人  社区卫生服务  卫生服务需要  卫生服务利用  卫生服务需求

英文关键词: the elderly  community health service  health service need  utilization of health service  demand for health services

中文摘要:

      目的 了解长宁区65岁及以上老年居民卫生服务需要及利用情况,分析老年居民对于社区卫生服务的需求意愿,为优化区域内社区卫生资源配置提供科学依据.方法 使用多阶段抽样方法,在长宁区抽取65岁及以上社区常住居民进行问卷调查.结果 共发放600份问卷,回收有效问卷575份,有效率95.8％.被调查的575人中慢性病总患病率为88.0％,合并两种以上慢性病的患病率为35.7％,患病率排在前3位的疾病是高血压(63.5％)、骨质疏松症(23.1％)和糖尿病(22.8％);共139人在两周内患病,两周患病率为24.3％,有73人到医疗机构就诊,就诊比例为54.5％.调查人群的两周就诊率为12.7％,随着年龄增长,就诊率升高(P=0.038).未就诊主要原因是自感病情较轻.老年人身体不适首选社区医院、区级、市级医院就诊的比例分别是60.2％、21.6％和17.3％.老年人选择社区卫生服务中心的主要原因包括距离近、收费低和态度好,他们最希望在社区医院得到的医疗服务是慢性病管理(41.1％)、中医保健(34.0％)和个人健康管理(30.7％).结论 长宁区老年人对于社区卫生服务利用程度较高、需求较大,应进一步加强社区卫生服务能力建设,为引导社区老年居民分级诊疗奠定基础.

英文摘要:

      Objective To investigate the demands of elderly residents aged over 65 in Changning District for health service and the utilization of the health service resources.Methods Questionnaire was conducted among the elderly residents aged over 65 selected by multi-stage sampling from the communities in Changning District,Shanghai.Results In total,600 questionnaires were sent out and 575 valid questionnaires were returned,the effective rate reached 95.8％;the total prevalence of chronic diseases was 88.0％,and that of 2 or more chronic diseases combined was 35.7％;the first 3 diseases were hypertension (63.5％),osteoporosis (23.1％) and diabetes (22.8％);139 elderly residents fell ill in 2 weeks and the 2-week prevalence was 24.3 ％;73 residents out of the 139 paid visits to medical facilities (54.5 ％) and the proportion was 12.7 ％,which went up with the increase of age (P=0.038);the main reason for not visiting doctors was the self contempt for the illness;due to the geographic convenience,low cost and good service attitude,60.2％ of the elderly,when they felt sick,made the first visit to community hospital,21.6％ of the elderly to district hospital and 17.3％ of the elderly to municipal hospital;when feeling ill,60.2 ％ of the elderly made their first visit to community hospital,21.6％ to district hospital and 17.3 ％to municipal hospital;short distance,low cost and good service attitude were the main reasons for the elderly to make their first visit to community health service centers;the greatest demands of the elderly for community hospitals included the management of chronic diseases (41.1％),health care with traditional Chinese medicine (34.0 ％) and personal health management (30.7％).Conclusions The utilization of community health care in Changning District is remarkably high and well acknowledged by elderly residents with huge demands;the construction of health care ability in community health care center should be strengthened so as to lay a certain basis for grading diagnosis and treatment.