| ObjectiveBy the field investigation, this study learns the current situation of the countryside inhabitant health service demand and utilization in Hubei Province, and explores the impact factors of them, then provides some policy suggestions to improve the inhabitants'health status.Methods1. Literature researchSome literatures were collected and researched, and correlation theory and research methods were grasped. These literatures were reported both home and abroad, which related mainly with people health service demand and utilization. The status and the trend of the countryside inhabitant health service demand and utilization were found out.2. Field investigation3 counties were selected by the standard of the good economic status or poor economic status, and 3 towns were selected by random sampling methods in every county, 6 countries per town, 10 households per country, and with 1831 people. The general situation of the counties, the status of the families and the status of the people health service demand and utilization were investigated by the unified questionnaire. The binominal logistic was used to find out the influence factors of the Situation of two-week illness, chronic illness, two-week treatment, the chronic diseases treatment and the hospitalized treatment. Z-test and Chi-square test were used to compare with the related data of the countryside in 2003 and in 1998.Main results1. The general situation of the countryside inhabitant and the need of the health service1.1 Prevalence of two week diseaseThe two-week prevalence rate was 24.09%, higher than the related data of the 1998 and 2003.The first biggest constitution ratio of the two-week disease is the respiratory diseases, second digestive system diseases, third both genitourinary system diseases and circulatory system diseases and forth kinematic scheme diseases. And every system disease was represented respectively by Influenza, Gastroenteritis, Hypertension and Gynecological diseases.The logistic regression analysis on two week prevalence showed at the significant of 0.05 that: (1)the gender and annual per capita net income made no difference to the two week prevalence; (2) the impact of non-married had no statistics significant, compared with the married; (3) the number of the family and the age made a difference to the two week prevalence; (4) the impact of the non junior secondary school education had a statistics significant, compared with the junior secondary school education; and (5) the impact of the non agricultural workers had a statistics significant, compared with agricultural workers.1.2 Prevalence of chronic diseasesThe investigation showed that the prevalence rate of chronic disease was 13.38%, higher than the related data of the 1998 and 2003. The order of constitute showed that the first one was circulatory system diseases, second kinematic scheme diseases, third respiratory diseases. The raw data showed that the different system diseases were represented respectively by Hypertensive heart disease, Rheumatoid Arthritis and CODP.3. Statistical methods The logistic regression analysis on chronic disease prevalence showed at the significant of 0.05 that: (1) the gender and the number of the family made no difference to the chronic disease prevalence; (2) the impact on chronic disease prevalence of non-married had no statistics significant, compared with the married; (3) the impact on chronic disease prevalence of the non junior secondary school education had non statistics significant, compared with the junior secondary school education; (4) the impact on chronic disease prevalence of the non agricultural workers had non statistics significant, compared with agricultural workers; and (5) the impact on chronic disease prevalence of the age and the annual per capita net income had a statistics significant.2 the demand for and the utilization of the health service2.1 Information of persons with physician contact within two weeksThe two-week prevalence rate was 13.82%, and made no difference to the related data in 2003(13.92%), but lower the related data in 1998(16.46%). Among these persons, 89.72% persons contact the physicians of the Three-tier health care network in rural areas.The logistic regression analysis on persons with physician contact within two weeks showed at the significant of 0.05 that: (1) the gender, the age and the status of taking part in the new type of cooperative medical care system or not made no difference; (2) the impact of non-married had no statistics significant, compared with the married; (3) the impact of the non junior secondary school education had non statistics significant, compared with the junior secondary school education; (4) the impact of the non agricultural workers had non statistics significant, compared with agricultural workers; and(5) the number of the family and annual per capita net income had a statistics significant.Information of persons with attendance for chronic diseaseThe attendance rate of chronic diseases was 8.14%, and the proportion was 61.07%. The chronic diseases were mainly constituted by circulatory system diseases, kinematic scheme diseases, respiratory system diseases and infectious diseases. The different system diseases were represented respectively by Hypertensive heart disease, Rheumatoid Arthritis, CODP and Hepatitis B.The logistic regression analysis on persons with physician contact for chronic disease showed at the significant of 0.05 that: (1) the number of the family and taking part in new type of cooperative medical care system or not made no difference; (2) the impact of non-married had no statistics significant, compared with the married; (3) the impact of the non junior secondary school education had non statistics significant, compared with the junior secondary school education; (4) the impact of the non agricultural workers had non statistics significant, compared with agricultural workers; and (5) the gender, the age and annual per capita net income had a statistics significant.2.3 Information of persons demand hospital serviceThe hospitalization rate was 5.4%, higher than the related data in 1998 and 2003. The hospitalization rate of the man made no difference to the women. The hospitalization rate had a trend of"√"with the age; the hospitalization rate had a small change according to the different education. The proportion of patient should but non-hospitalized was 27.10%, higher than the related data in 2003 and the proportion of women was higher than that of the man. Poor economy had a proportion of 75.40% among the reason why should but non-hospitalized.The hospitalization rates were different according to the age, the marital status and the professional category. But the impact on hospitalized rate of the age, the marital status and the professional category had no statistics significant.Suggestions1 Strengthening the common disease's prevention and treatment The common diseases in rural area are Influenza, Gastroenteritis, Hypertension, Gynecological diseases, Rheumatoid Arthritis, CODP and Hepatitis B. The medical and health organization of the location should prepare treatment medicine and therapeutic schedule according to the different characteristic of the diseases.2 Carrying out disease's prevention and the treatment aiming at the specific crowd The demand of the different crowd is multiple. The health service providers should carry out the related diseases prevention and treatment according to the characteristic of the different crowd, such as children, the women and old people.2 Government and administration of public health department's suggestionsIt is important to confirm the government's health responsibility, and fulfill government's function in the rural sanitation domain. Consummating the sanitation structure in rural area will play an important role in adapting the new change of the health service needs and demands. The hygienic economic policy should be reformed and consummated so that the public health can develop unceasingly. The health education should be strengthened and the scientific healthy behavior should be advocated so that all the people health consciousness can be raised. |
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