Research On The Demands And Utilization Of Health Service For The Elderly In Ningxia Mountainous Areas And The Analysis On Its Influencing Factors

Objective: This dissertation explores the demands and utilization of health service for the elderly and its influencing factors in Ningxia mountainous areas, through analyzing the demographic characteristics, living behavior, self-assessment of health, health service demands and the utilization of health service for the elderly in mountainous area in Ningxia Autonomous Region. It will provide the scientific basis for satisfying the health services demand of the rural elderly better, improving their quality of daily life, and giving more effective and reasonable service for mitigating and controlling the chronic diseases of the rural elderly.Methods: The quantitative research was mainly applied in this study. The method of two-stage stratified random cluster sampling, which was applied in this baseline survey, was used to do the household surveys for the rural residents in the Counties of Haiyuan, Yanchi, Xiji, Pengyang, and Tongxin in Ningxia Autonomous Region. Questionnaires were collected immediately at the end of the preliminary investigation. Then, we checked and filtrated the elderly 60 and above to analyze the indexes of the demographic characteristics, patients' first treatment flow tendency,health service demands and the utilization of health, with descriptive statistics and the method of univariate analysis. The multivariate LOGISTIC regression model was used for analyzing the influencing factors of the utilization of health service. The software of data entry was the Epidata3.2 and the analysis software was SPSS13.0.Results1. General situation of subjects in this study, male accounted for 51.5%, female accounted 48.5%, the sex ratio was 100:94.32; Han was 52.3% and Hui was 47.7%; average age was(68.6±7.1) years old. Female illiteracy was more than male illiteracy while people who had primary school education in male were higher than those in female. 14.7% of elderly people smoked and the difference of smoking prevalence between male elders and female elders showed the statistical significance(?2=590.050, p<0.01). Among 3593 elderly people, there were 2474 showing answers of self-rated health and the response rate was 68.9%. Men is 53.3% and women is 46.7%. The differences of sex ratio in self-rated health is statistically significant(p<0.01).2. Demands of health service: two weeks' prevalence rate of the elderly was 24.7% while the prevalence rate of chronic disease was 47.9% in elderly people of Ningxia mountainous areas. The main chronic diseases in order were hypertension(26%), heart diseases(4.8%), lumbar disc herniation(3.4%), arthritis(3.3%), diabetes mellitus(3.2%), cerebrovascular diseases(3%).3. Utilization of health service: the most common choice for the elderly of their first treatment was the county hospital(33%), next was township hospitals(25.6%). The two-week consultation rate of elderly patients was 11.4%, and the annual outpatient rate was 24.4%.4. The multivariate LOGISTIC regression model was respectively used for theDemographic characteristics and motility, women, high age, rise of income, low self-evaluation of healthwasthe risk factors of two weeks prevalence. Women, high age, risk of income, Non-agricultural population, difficulty in waking, low self-evaluation of health was the risk factors of Prevalence of chronic diseases.The Hui nationality, High-cultural level, destitute Families was the protective factors of Prevalence of chronic diseases.Elderly patients that is suffering from hypertension, heart disease, difficulty in waking, rise of income was the risk factors of elderly patients' two-week consultation rate. Women, high age, rise of income, smoking habit, low self-evaluation of health and sufferingcerebrovascular disease was the risk factors of higher hospitalization rate, destitute Families and suffering arthritis showed lower hospitalization rate.Conclusion: The demand of health services for the elderly in rural areas ishigher, and high prevalence of hypertensionis becoming the main diseases that threaten the health of the elderly in rural areas. Some elderly people still have the habit of smoking, so the tobacco control should be propagandized and educated intentionally. The flow of patients of level of village, township / town's medical and health institutions is lower than county hospital, so it is needed to further strengthen the construction.