| ObjectiveTo understand the current situation of health service needs and utilization of rural residents aged 60 and above in Henan Province,and analyze the factors that affect their health service needs and utilization.Provide reference for rational allocation of health resources,improvement of health service utilization of the elderly in rural areas,and scientific formulation of health policies.MethodsThe multi-stage stratified cluster random sampling method was used to study the rural residents aged 60 and above in Henan Province.Use the Family Health Questionnaire for face-to-face household surveys.Descriptive statistical analysis of residents' basic characteristics,two-week prevalence rate,two-week prevalence disease composition,two-week visit rate,two-week first-visit medical institution,one-year hospitalization rate,and one-year hospitalization medical institution.Chi-square test or rank sum test was used to analyze the two-week prevalence,two-week visit rate,and one-year hospitalization rate by single factor analysis.The Logistic regression model and decision tree model were used to analyze the influencing factors of two-week prevalence,and the influencing factors of two-week visit rate and one-year hospitalization rate were analyzed using Logistic regression model.Results1.Two-week prevalence:The two-week prevalence of rural elderly is 47.05%.The results of single factor analysis show that female,75 years old and above,have not attended school,widowed/divorced,annual per capita income below 4000 yuan,family poverty/low living allowance,suffer from 3 or more chronic diseases,participate in health checkups and have no health records with high health records have a two-week prevalence.Logistic regression model results show that education level,poverty/minimum living security,and types of chronic diseases have an effect on the elderly two weeks of illness.The results of the decision tree model show that types of chronic diseases,poverty or subsistence allowances,gender,whether to participate in health checkups,and marriage have an impact on the rural elderly for two weeks,and the area under the ROC curve The difference was not statistically significant(P>0.05).2.Two weeks of disease composition:According to the analysis of disease system,the top five diseases are circulatory system diseases,aspiration system diseases,endocrine,nutritional and metabolic diseases and immune diseases,digestive system diseases,musculoskeletal system and connective tissue diseases.It accounted for 93.66%of the number of patients with the disease in two weeks.The top five by disease category are hypertension,diabetes,cerebrovascular disease,acute nasopharyngitis(common cold),acute and chronic gastroenteritis,accounting for 78.76%of the number of patients affected in two weeks.3.Two-week consultation:The two-week consultation rate of the elderly is 28.26%.The results of single factor analysis show that female,70-74 years old,have not attended school,widowed/divorced,annual per capita income below 4000 yuan,family poverty/low living allowance,receive minimum living allowance,suffer from 3 or more chronic diseases,moderately disabled,hard to hear,have moderate vision difficulties,participate in health checkups,and have the distance to the nearest medical unit within 1 km have a higher two-week consultation rate.The multi-factor Logistic regression analysis shows that marriage,annual per capita income,whether they are poverty/minimum living security,economic sources,types of chronic diseases,hearing status,and vision status are influencing factors for the elderly to see a doctor in two weeks.Village-level medical institutions accounted for 59.78%of the first consultation in two weeks,township-level medical institutions accounted for 19.84%,county(district)-level medical institutions accounted for 13.54%,municipal-level and above medical institutions accounted for 1.09%,and others accounted for 5.75%.4.Hospitalization within one year:The hospitalization rate of the elderly within one year is 19.57%.The results of single factor analysis show that 70-74 years old,unmarried,family poverty/low living allowance,supported by other members of the family,suffering from 3 or more chronic diseases,moderate disability,audible,moderately visually impaired high.The multi-factor Logistic regression analysis shows that the influencing factors for the elderly hospitalization within one year are marriage,whether they are poverty/minimum living security,economic sources,types of chronic diseases,disability,and vision status.Among inpatient medical institutions,township-level medical institutions account for 22.02%,county(district)-level medical institutions account for 50.38%,municipal-level and above medical institutions account for 20.75%,and others account for 6.85%.Conclusions1.The elderly in rural areas in Henan Province require a large amount of health services,and chronic diseases are the most important factors affecting the needs of health services.We should focus on the health service needs of the elderly such as chronic diseases,women,never going to school,widowed/divorced,family poverty/minimum living,and continue to increase the prevention and publicity of chronic diseases.2.The elderly in rural areas in Henan Province have a relatively high utilization rate of outpatient and inpatient services,and the types of chronic diseases,marital status,poverty/low-income security,economic sources,and vision status are influencing factors for the utilization of health services.Therefore,when improving the utilization of health services for the elderly in rural areas and formulating relevant health policies,these factors can be properly referred to.3.The use of outpatient services is more reasonable,and the use of inpatient services needs to be improved.The implementation of the three-level diagnosis and treatment policy should be intensified,the construction of the county medical community should be continuously promoted,and the medical and health resources should be reasonably allocated. |
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