| ObjectiveIt is important to study the requirements and utilizations of health service including their affecting factors. In recent years, the requirements and utilizations of health service have changed remarkably. Reporting illness and seeking medical care within 2 weeks are important indexes of health service requirements and utilizations, which have many affecting factors and their relationships are complicated. Some researches have been done internal and external but many affecting factors are inconsistent in those researches.Structural equation model is a method of linear statistical modeling, which makes the observed variables indicate the latent variables and allows the observed and latent variables have measurement errors. It can research not only the observed and latent variables but also the direct and indirect effect between these variables. In this study, structural equation model was used to analyze the relationship between the reporting illness > seeking medical care within 2 weeks and their affecting factors ^ latent variables.Materials and methodsThe data in this study came from the family health survey of Zhejiang Province in 1998. 7200 families from 12 counties were selected by four-stage cluster sampling. A total of 2906 residents lived in urban area and 16278 residents lived in rural area aged 15 or over were included for analysis. The content of the survey was composed of (1) general characteristics of family members; (2) economic state > housing conditions and surroundings of the family; (3) health insurance situation andacquirement of health service of family members; (4) circumstance of family members about whether they had illness within 2 weeks and chronic disease within recent half year and whether they went to see doctors.The whole participators were divided into urban population and rural population in analysis. The original model had 9 latent variables, which were indicated by 20 observed variables. SAS 6.12 was used to fit the structural equation model and the parameters were estimated by ADF method.ResultIn urban model, morbid status and economic conditions had direct effect on reporting illness within 2 weeks and the standardized coefficients were 0.3854 and -0.0604. Social factor and physiological conditions influenced reporting illness within 2 weeks indirectly through morbid status, the standardized coefficients were -0.2012 and 0.0513 respectively. Residents' seeking medical care within 2 weeks was influenced indirectly by all factors except the reporting illness within 2 weeks. The standardized coefficient of reporting illness to it was 0.6663. According to their influence to seeking medical care, those indirect factors were morbid status > social factor ., economy conditions and physiological conditions orderly and their standardized coefficient were 0.2568 > -0.1341 > -0.0402 and 0.0342 respectively.In rural model, morbid status x sanitary conditions of family and social factor influenced the reporting illness within 2 weeks directly and their standardized coefficients were 0.4415s 0.1410 and -0.0586 respectively. Economic conditions not only had direct effect but also had indirect effect on residents' reporting illness through sanitary conditions of family and morbid status. The total standardized coefficient of economy conditions was -0.1242. Physiological conditions influenced residents' reporting illness within 2 weeks indirectly through morbid status and the standardized coefficient was 0.1581. Residents' seeking medical care was influenced by all factors. Reporting illness had direct relationship to it, the standardized coefficient was 0.7552. Economy conditions had both direct and indirect effect on it, the total standardized coefficient was -0.1154. Other factors had indirect effect on it.According to their influence, those indirect factors were morbid status, physiology condition, Sanitary conditions of family and social factor orderly and their standardized coefficients were 0.3334, 0.1194> 0.1065 and -0.0443.ConclusionIn th...
|
PDF Full Text Request