| Backgroun and ObjectAlong with the rapid development of living quality, prevalence rate of Noncommunicable Diseases (NCD) increases year after year. NCD have become main diseases affecting health of inhabitants. The burden of NCD increases rapidly in all of the world. NCD patients pay more and more attention to community health service (CHS) presently. How to develop CHS and prevent and cure chronic diseases in community has become prior research area in all levels of health administrative departments.The purpose of this study is to explore the local pattern of NCD and the economic burden caused by NCD, analyze the expense in different level hospitals, study the status and effect of CHS on preventing and curing NCD, and provide the reference for decision-making of CHS progress.Material and MethodsThis study was carried out in Jiangdong district of Ningbo city in which there were 7 streets, 77 communities, 107875 families and 292552 inhabitants. The study includes two parts: local health service resource investigation and family investigation. All health service institutions in Jiangdong district were investigated, and two-phase random sampling method was used for the inhabitant subjects. The questionnaire included demographicd characters, family economic status, medical insurance status, diseases diagnosis and treat in the past two weeks and in the past one year just before investigation.The pattern of main NCD was described with frequency and percentage, and economic burden was described with median and semi-guartile range. Corresponding analysis was usedto analyze the relationship between hospital preference and factors such as: age, education, employment status, income, occupation, kinds of disease , medical insurance, etc by procedure Anacor in SAS 8.02;age, education, employment status, income and occupation was analysed using cluster analysis;according to results of cluster analysis , some variables were analysed using homogeneity analysis.ResultsThe leading five diseases during the past two weeks of habitants were cold, hypertension, coronary heart disease, gastric disease and diabetes;those during the past one year were cold, hypertension, gastric disease, diarrhea and coronary heart disease. Both of the leading five NCD during the past two weeks and the past one year were hypertension, gastric disease, coronary heart disease, diabetes and chronic bronchitis. The average hospitalized time for main chronic diseases was over 3. The average medical expense was about $ 1500, while the highest average expense was $ 6000 for cancer. The average non-medical expense was about $ 50. Medical expense of some diseases such as diabetes, chronic bronchitis, gastric disease in municipal or district hospital was far higher than that in community or private hospital.The hospital chosen by most inhabitants was both municipal hospital in past two weeks or in past one year (55.3% and 57.7% respectively), followed by community hospital (25.1% and 26.1% respectively).The factors influencing hospital preference included age, education, employment status, income, occupation, type of diseases and way of medical insurance. The results of corresponding analysis showed that the point representing inhabitants, age less than 20 years, and another point representing municipal hospital were near and in the same second quadrant, which indicated the two points were to related closely and inhabitants, age less than 20 years, were inclined to community hospital for medical service. With the same reason, inhabitants, age over 50 years, prefered municipal hospital, and inhabitants, age over 65 years,were inclined to district hospital (accumulate contribution rate of the leading two inertias was 0.987 in the corresponding analysis of hospital and age). Illiterate was to related with district hospital closely, those educated senior school prefered municipal hospital (accumulate contribution rate of the leading two inertias was 0.984 in the corresponding analysis). Retired inhabitants were inclined to municipal or district hospital, and unemployed inhabitants mainly chose community hospital or private hospital (accumulate contribution rate of the leading twoinertias was 0.995). As to the economic status, inhabitants with monthly income less than $ 500 mainly chose community hospital, those with monthly income $ 500 ~ mainly chose municipal or private hospital, those with monthly income $1000-and $2000~ chose municipal hospital mainly (accumulate contribution rate of the leading two inertias was 0.995). The relationship between occupation and hospital preference is: those engaged in technology or farming, forestry and husbandry or other career were inclined to municipal hospital, commercial or service occupation to private hospital, manufacture and carrying trade to community hospital (accumulate contribution rate of the leading two inertias was 0.989). The corresponding relationship between type of diseases and preferred hospital was: diarrhea and trauma to community hospital, cold to private or other hospital, gastric disease to district hospital, hypertension and diabetes to municipal hospital (accumulate contribution rate of the leading two inertias is 0.878). The relationship between type of medical insurance and hospital preference was: medical insurance or overall planning or cooperating insurance to private or other hospital, public expense or labor insurance to district or municipal hospital, at one's own expenses to community hospital or private hospital (accumulate contribution rate of the first inertia wass 0.978). The main reason choosing community hospital was short-distance. The main reason choosing district or municipal hospital was high-quality, nice service manner and being appointed hospital (accumulate contribution rate of the leading two inertias is 0.979).According to results of cluster analysis, age and employment status were in a cluster;education, income and occupation were in another cluster. The result of homogeneity analysis carried between employment status and education level showed that there was some relationship between choosing community hospital and employment status being unemployed and education level being illiterate, and that choosing district hospital was related with employment status being in school or retirement and education level being elementary school.ConclusionNCD has become one main factor affecting the health of inhabitants and has brought on high disease economic burden.The factors influencing habitants' hospital prefrerence include age, education level, employment status, occupation, income, type of diseases, type of medical insurance, equipment of medical resource, medical quality and service manner. Among them, low age, unemployment, low income, taking medical treatment at one's own expense and occupationof manufacture or transport service are the main factors related to choosing community hospital, and short-distance was another main factor.Community health service has attracted many inhabitants and been approved by some inhabitants, but the number of old people or patients with chronic disease to community hospital is still small. And comprehensive measures to prevent and cure chronic diseases in community are not carried out adequately. So, great effort should be made in many respects to develop community health service with great exertion.
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