Health Services Need And Utilization Of Residents In Lintan County Of Gansu

Objectives:To provide the baseline information on Lintan county’s health care situation and fill in Gannan region based on the research on the health care service need and utilization, and to provide the health care report with the regional character which can reflect the health realistic situation on Lintan county and to provide the policy decision-making recommendations and suggestions for Linan and Gannan.Methods:The 5th National Health Services Survey in 2013 were the main datum source, while literature reviews, interviews and field observation methods were used alongside to obtain descriptive information about the public health situation. Software Excel 2007 was used for database building and management while SPSS 19.0 was used for the descriptive analysis and effective factors statistical analysis.Results:1.27.7% of surveyed households whose distance to the nearest medical institute were within lkm, and 25.2% were within 5km. For the arrival time to the nearest medical institution,36.2% were within 10 minutes, and 20.2% required more than half an hour to arrive at.2. With the 600 surveyed households, the poverty household accounted for 30.3%, and low-income households accounted for 43.5%. The main causes of poverty were as follows, labors lackness which accounted for 20.7%, followed by natural conditions or by disasters for 15.8%, and diseases caused accounted for 3.3%.3. The participation rate of medical insurance among survey residents was 99.10%. Among them, the participation rate among rural household registration residents was 99.88%, mainly through the New Rural Cooperative Medical System (NCMS), at 99.30%. The participation rate among the urban household registration residents was 75.86%. Government Medicaid covered 342 people, accounting for 17.9% of the total study population.4. The number of people aged 18 years and above in the survey was 1443.13.3% had low weight occurrence rate (males 8.7%, females 17.2%),16% were overweight, and 1.9% were obesity, with higher rates of overweight and obesity among males than among females. Of the self-evaluation indicators of health, the highest proportion of people had problems in dimension of pain/discomfort. Females, the elderly, uneducated people and patients with chronic disease had lower self-evaluation scores than other groups.5. The two-week prevalence of disease among residents was 17.3%, and higher among females than males, which were dominated mainly by new disease within the two weeks. The top three diseases in the two-week prevalence were acute nasopharyngitis, hypertension, and influenza. The prevalence of chronic diseases among surveyed residents aged 15 and above was 25.1%; the uppermost three prevalent chronic diseases were hypertension, rheumatoid arthritis, and other chronic obstructive pulmonary disease. Prevalence of hypertension and diabetes was concentrated mainly in the 65 and older population, with a higher prevalence rate among the Hui people than among other ethnic groups.6. The rate of persons with physician contact within two weeks was 12.2% according to the number of people, and 15.5% according to the number of person-visits. The proportion of two-week patients who saw a doctor was 73.8%. By multiple factor analysis, ethnicity, household population, distance to the nearest medical center, and chronic disease status were the main factors affecting the two-week consultation rate.7. The rate of persons with hospital admission within twelve months was 7.2% according to the number of people, and 7.5% according to the number of person-visits. The primary reason for hospitalization was childbirth. By multiple factor analysis, sex, age, ethnicity, marital status, and chronic disease status were the main factors affecting the utilization of inpatient services.Conclusions and Recommendations:The participation rate on health insurance coverage is quite high for the rural population in Lintan, and the health service access has also gradually improved. The low weight rate among childbearing age women is a serious problem in Lintan county while; the overweight rate is not high, besides the residents aged 45 to 54. The hypertension prevalence is not high either, while those 65 years or older’s prevalence is 20%. And the rates of hypertension and diabetes controlling are very low. The demography factors, medical conditions and health status are the effective factors of health services capacity in Lintan. Otherwise, unreasonable flow directions of patients seeking medical services as less in-patients choose the township hospitals or community health service centers. Here are the recommendations and suggestions for the decision-making:(1) Improving the primary health care service network. (2) Strengthen the improvement of human resource in rural health services. (3) Improving the basic medical insurance system. (4) Improving the basic health services for the focus groups’ health demand. (5) Improving the efficiency of resource allocation by hierarchical diagnosis system.