Factors Of Community Health Service Patients With Chronic Use

ObjectivesTo know the prevalence, health services utilization, and to analyze influencing factors to find the possibility to promote health services. In order to promote reasonable utilization of all levels health services by finding and improving the medical and health services to chronic diseases patient. And the survey results can provide a reference with relevant department to adjust the supply-demand balance and guide the medical direction more reasonable.MethodsSelecting Health Services Demand and Utilization Questionnaire and unstructured interview to survey community patients with chronic diseases, which was designed by myself and based on previous studies.SPSS20.0was used to analyze the outcome, which included descriptive analysis, chi-square test and logistic regression analysis for segment information.Results1.511questionnaires were retrieved in effect, which included261patients in old city subdivision and250patients in new city subdivision. The highest proportion was hypertension reached43.44%in overall chronic diseases, which contained people who had pure one kind of disease or more. And the proportion of hypertension was the highest in one kind of diseases.2.43.05%patients obtained health knowledge via newspaper, broadcast and TV,33.07%patients done this by talking with doctors. The study showed that, the factors of influencing patient’s to get health knowledge were sexy, whether to live alone or not, educational level, income. Meanwhile, the higher the educational level and income patients had, the lower the rate of not getting health knowledge consciously. Outpatient service was used most frequently,75.71%patients had experience, and the next two manners were telephone service and home service.3.67.71%patients selected primary health care institution as first diagnoses institution.8.61%patients selected hospital as first diagnoses institution, which contain 46.2%patients had common disease and28.2%patients were in acute period of chronic disease. The three important reasons of selecting primary health care institution as first diagnoses institution were short distant, low consume and good service attitude. On the contrary, the higher medical skills and complete medical facilities were main reason to patients to selected hospital as first diagnoses institution. Besides,8.81%people could not make fixed choice. The result of Logistic regression analysis showed that patients’first diagnoses choice was influenced by city subdivision, Medical insurance and confidence degree to community health service.4. The frequency of27%patients who went to primary health care institution was less than three times, and the frequency of38%patients was4-11times, the frequency of the rest of the patients who went to was more than12times. The factors of influencing patient’s utilization of primary health care institution were city subdivision, marital status, employment status, income, whether there were two or more kinds of diseases or not, whether to participate in community outpatient serious diseases covered by Risk-pooling Found and patient’s evaluation to community chronic diseases management.Conclusions and RecommendationsCurrently, hypertension, diabetes and coronary disease were the main diseases that patients suffered from, and quite a few of people had more than one kind of diseases. Aging patients were the target to carry out chronic disease management. To communicate with doctors has been an important way to obtain the knowledge. The result of Logistic regression analysis showed that patients’first diagnoses choice and patient’s evaluation to community chronic diseases management were all influenced patient’s confidence degree to community health service. Besides, there were two problems:the lower health technology level and drugs were not complete. The detail suggestions are concluded:1. To carry out chronic diseases screening, and pay more efforts to old people’s healthy check-up.2. Extending the list of essential medicines, and reducing the distance of social security medicine directory.3. Innovating service means of community health service institution to close to patients, and improve patient’s confidence degree to community health service.4. Establishing medical commonwealth, and improving the ability of providing health services.5. To enhance staff’s consciousness to service, and improving the pertinence of health education.