Exploring Factors Related To Rural Poverties' Health Service Need And Utilization In Sichuan Province

Objectives To study the rural poverties' health service need and utilization in Sichuan province. To explor the influence factors related to their health service need and utilization with the appropriate statistical methods based on the characteristics of the data, and to provide objective and scientific evidences related to policies. To probe into applying multilevel models to the analysis of household health interview survey data as well as to provide methodological references to similar studies.Methods The enlarged household health interview survey data of rural residents of the Third National Health Service Survey in Sichuan province was described in detail. Two-level logit regression model was used to explore the influence factors related to two-week prevalence, chronic illness prevalence and health service utilization by patients who were suffering in latest two weeks.Results The data are good representation of rural residents of Sichuan. Two-week prevalence and chronic illness prevalence of poverties are 208.28%o and 161.39%o respectively. 40.8% patients thought their illness were serious.Two weeks sick days, days suspending from work per thousand people, days keeping the bed per thousand people are 1621.19, 586.83, 334.65 days respectively. Persons with or without physician contact within two weeks are 274.06‰ and 37.13% respectively. Persons with or without hospital admission within twelve months are 41.72‰ and 47.71% respectively. The primary reasons of patients without physician contact within two weeks and persons without hospital admission within twelve months is poor economy.There are 72.9% inpatients asking for leaving hospital due to their poverty. The anterior three diseases are respiratory system, digestive system and connective tissue ranked by both systemetic specific two-week prevalence and patients with physician contact within two weeks. Diseases of digestive system, connective tissue and respiratory system are the anterior three system arranged by systemetic specific chronic illness prevalence. Diseases of digestive system, respiratory system, damnification and toxicosis are the anterior three system ranked by systemetic specific persons with hospital admission within twelve months. Main factors related to the two-week prevalence of the rural poverties aged 15 years and above are age, gender, chronic disease, drink, marriage status, living area per capita in a family and education. Main factors related to chronic illness prevalence are age, marriage status, education, acquiring actively and the evaluation on his or her own health. Accessibility for the health service, serious degree of the disease, health insurance, acquiring actively, chronic disease and age are the key factors to patients with physician contact within two weeks.Conclusion Economic straitness leads to the higher health service need and lower health service utilization for rural poverties. It is necessary to implement new cooperative medical scheme and medical financial assistant aiming at the poorest population to improve the situation of health service in rural areas. We should pay more attention to health care for women and the elderly in order to improve the health inequity among different people. It is very important to increase the knowledge of prevention and cure of disease by strengthening health education among the rural poverties.