Study On Need And Utilization Of Health Service In Hefeng County,Hubei Province

Objective:This study conducted a questionnaire survey in Hefeng County's residents to collect data of their required level of health services through a home study and to learn and discuss about the situation and influence factors of health services utilization among the different demographic characteristics population in order to provide reference for poor area's health administrative department when making relative policies,improving the poor ethnically mixed area's health related policy and providing data support and then reasonably regulate local area's health services supply and promote better deploying and utilization of the developing area's health resource and improve the local resident's living quality and health situation.Methods:?Hefeng county's health resource's level on allocation and relative policies were investigated through literature review and on-site interviews.?400 families,total 1325 residents were interviewed about their family health's situation by household survey.The questionnaire of National Health Services Survey were used to describe sociological characteristics of local residensts in Hefeng county;quantitative research were conducted to analyze the resident's health situation,health resource needs and utilization among different ethnics and economic classes,and the main impact factors.?Epidata3.0 and SPSS 17.0 were used to collect and analyze the data.Result:(1)Resident's two-week prevalence rate was 11.5%.The highest rate was respiratory system diseases,then was the circulatory system diseases,and the third was musculoskeletal system diseases;The main diseases were mainly high blood pressure,acute upper respiratory tract infection and rheumatoid arthritis.The multi-factor regression analysis showed that the main impact factors to resident's two-week prevalence rate were employment status,age,and poor or not.(2)Prevalence of chronic diseases:Among the residents who aged older than 15,the prevalence rate of chronic disease was 21.4%;the top three diseases were from musculoskeletal system,circulatory system and respiratory system;the main diseases were rheumatoid arthritis,the high blood pressure and chronic bronchitis.The multi-factor regression analysis showed that the main impact factors on whether or not the residents suffering from chronic diseased were employment status,age,and poor or not.(3)Residents' two week visiting rate to outpatient department was 7.3%;patients' two week visiting rate to outpatient department was 63.4%;patients' two week not visiting rate was 36.6%.The multi-factor regression analysis showed that sex was the main impator factor to whether or not patients to go to clinic.45.4%patients' choice was county hospital as their first visiting health institution.The multi-factor regression analysis showed that age and whether or not suffering from chronic diseases were the main impact factors on whether they chose county hospital as the first visiting health institution.(4)Residents' hospitalization rate was 5.4%according the number of patient and 6.3%according to the number of patients to go to clinic respectively.No hospitalization rate was 19.3%,and the primary reason for not going to hospital was economic difficulties.The multi-factor regression analysis showed that the main impact factors to residents' hospitalization use were whether or not suffering from chronic diseases,household typ,and the shortest distance to the nearest health institution.Conclusion:The two-week prevalence rate and the prevalence of chronic diseases of Hefeng County residents increased,which indicated that health care needs increased in Hefeng Country.Disease spectrum of residents changed.Unemployed or jobless residents,the elderly and the poor households were health vulnerable groups in the local,and their health needs were greater than other groups.In addition,two-week visiting rate to outpatient department of residents and two-week visiting rate to outpatient department of patients all decreased;two weeks no visiting rate to outpatient department of patients increased;the utilization of medical services declined.Female,agricultural population,residents of the poor health service accessibility may be the vulnerable groups for the use of medical services.Patient flow was not reasonable;the chronic disease was the important factor for the residents to consider the utilization of health service Factors.Therefore,the local medical institutions should provide the health needs of different populations with targeted medical services and reasonable treatment programs,and actively carry out disease prevention and medical work based on local types and characteristics of common diseases;In addition,the government and the health administrative departments should increase the health investment in the poverty-stricken ethnic minority areas,rationally allocate health resources,improve the primary health care service network system,strengthen rural health human resources construction,improve health service utilization.The basic medical insurance system construction should be improved through multiple channels;the basic health services should be focused on the key population;pay attention to the change health needs of residents and the effective integration of the medical service system;chronic disease prevention and control network of key population and grading diagnose and treatment system should be established to improve health resource allocation efficiency.