| Objective:To find out the characteristics of utilization and demand of basic public health services for chronic patients in Yunnan Province by understanding the current situation of utilization and demand of basic public health services for chronic patients in Yunnan Province.To explore the influencing factors of the demand and utilization of chronic disease patients in Yunnan Province,so as to provide basis for further formulating basic public health projects,rationally allocating health resources and improving relevant policies.To improve the utilization rate of projects for patients with chronic diseases,meet the needs of patients with chronic diseases,improve the health status of patients with chronic diseases.Method:with the method of stratified random sampling and random sampling completely,according to the difference of each extraction of 16 cities in Yunnan province GDP good state/city,A community/township health center was randomly selected among the prefectures/cities selected.Total random sampling method was used in each community/township area to select permanent chronic disease patients according to the list of accounts included in chronic disease management,and a total of 1530 chronic diseases patients were selected.A questionnaire survey was conducted by using self-made questionnaires to investigate the current situation of patients’utilization of basic public health services,their demand for undeveloped services,and the main influencing factors.The current situation of demand and utilization is analyzed by statistical description,analysis the influence factors of the chi square test and logistics regression analysis,In order to solve the problem of multiple linearity in demand factor analysis,factor analysis and principal component analysis are used to classify the basic public health services that have not been carried out,and linear regression analysis is made with the factor scores after classification.Results:1.A survey was conducted on the utilization rates of five projects carried out,and the standardized utilization rate of chronic disease patients for five projects is 58.07%.Compared with the standard utilization rate of chronic disease patients in eastern and coastal areas of China the standard utilization rate of chronic disease programs in Yunnan province is lower.2.The project utilization in patients with chronic diseases mainly by nation,and family economic conditions,regional economic conditions,cultural degree,satisfaction,health status and health insurance,the influence of the han nationality,family economic condition,the better,regional economic development,the worse,primary school and the following cultural degree,satisfaction,and the better health with a chronic illness for basic public health services utilization rate is higher;The utilization rate of patients with chronic diseases who buy new rural cooperative medical insurance is higher than that of patients with chronic diseases who buy other medical insurance.3.For patients with chronic diseases,the top three services with the highest demand rate for undeveloped projects are B-ultrasound examination,hematuria and electrocardiogram examination.Different patients with chronic diseases have different needs for services that have not been carried out.Diabetes patients have higher demand for Ophthalmology,mental comfort and door-to-door services than hypertension patients.4.In the basic medical service demand,cultural degree,willingness to pay and career is the main factor of hypertension diabetes basic medical service demand,further perfecting the grassroots health infrastructure,improve the level of medical staff of medical technology,enlarging the grassroots health resources configuration,meet the low level of education,enterprises and civil servants and a willingness to pay of hypertension and diabetes patients demand for basic medical services.5.Among the factors affecting the demand for basic medical services for patients with hypertension and diabetes,the main factors affecting the demand for basic medical services for patients with hypertension are:age;The main factors affecting the demand for basic medical services for patients with diabetes are:residence,complications,regional economic development,health status and medical insurance;Among the factors influencing the demand for health promotion services for patients with hypertension and diabetes,the main factors influencing the demand for health promotion services for patients with hypertension are:gender,age,place of residence and medical insurance;The main factors affecting the demand for health promotion services for patients with diabetes are:complications and regional economic development.Among the factors that affect the demand for door-to-door service of hypertension and diabetes patients,the main factors that affect the demand for door-to-door service of hypertension patients are:age,place of residence,family economic status,regional economic development status,health status,willingness to pay and medical insurance;The main factors influencing the demand of diabetes patients for home service are:complications,regional economic development and marital status.Conclusions:1.The standardized utilization rate of the projects carried out by the patients with chronic diseases is low,which may be related to the special geographical location of Yunnan province.Compared with the coastal areas of FuJian province,its economic development is relatively backward,and the transformation of residents’ ideology is relatively backward,Theacceptance of some new things is relatively blocked,and the awareness of the utilization of existing project norms is not strong,which needs to be further strengthened in the subsequent project management of chronic diseases.2.The utilization of chronic disease patients is mainly affected by ethnic and health conditions.It is suggested that medical staff should strengthen health education for ethnic minorities,raise health awareness of ethnic minorities,improve health status and health literacy of patients.At the same time,the government should carry out services according to local characteristics and local conditions.3.Patients with chronic diseases have different needs for 12 items that have not been carried out.The top three items with higher demand rate are B-mode ultrasound,hematuria and electrocardiogram.It is suggested that the basic public health service in the next step can increase the corresponding service according to the needs of the patient and provide more accurate and personalized services to meet the needs of the patient.4.In the basic medical service demand,cultural degree,willingness to pay and career is the main factor of hypertension diabetes basic medical service demand,further perfecting the grassroots health infrastructure,improve the level of medical staff of medical technology,enlarging the grassroots health resources configuration,meet the low level of education,enterprises and civil servants and a willingness to pay of hypertension and diabetes patients demand for basic medical services.5.In terms of health promotion,is national,cultural degree,health status and occupation affect patients with hypertension and diabetes health promotion service demand,the main factors suggest that basic public health services in the next step of work from ethnic minorities,the higher the level of education and health of patients of the worse,strengthen minorities and poorer health of health promotion in patients with hypertension and diabetes propaganda and education,improve their health consciousness,to meet the needs of health promotion in patients with hypertension and diabetes.6.In the field of door-to-door service,the willingness to pay is the main factor affecting the demand for door-to-door service for hypertension patients,and different payment methods are suggested for the newly increased service fees for hypertension patients.One is to carry out cost-benefit analysis according to the balance of financial allocation and local funds,and formulate corresponding charging standards to ensure the accessibility and fairness of public health services.The other type can learn from the management plan of foreign basic public health service projects,and provide certain subsidies to the medical services of the vulnerable groups according to the local financial situation,aiming at the special groups and vulnerable groups,so as to further improve the public welfare of the projects. |
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