| Objective:This study investigated and analyzed the status of medical treatment and related influencing factors of the elderly population in Guangdong(Guangzhou Liwan and Qingyuan Yingde).It includes the analysis of the factors influencing the treatment of elderly patients and the factors influencing the level of medical institutions,so as to understand the relevant situation in elderly medical treatment and found problems,thus to improve the elderly’s medical environment,promote the health of the elderly,improve the relevant health policy to provide a reference.Methods:By using multi-stage random sampling,8 streets were randomly selected in 22 streets of Guangzhou Liwan,and 5 towns were randomly selected in 24 streets/towns in Qingyuan Yingde.In each street or town in accordance with the household units,randomly selected elderly people to investigate.The research method is based on literature analysis,expert consultation,current survey and statistical analysis.Statistical analysis methods:(1)Descriptive statistical analysis,using percentages,card-side test to describe the characteristics of the population and medical treatment.(2)Single factor analysis,using the card-square test,rank and test,Fisher exact probability method to analyze the population characteristics and medical treatment of the elderly population,the different demographic characteristics and the type of health care institutions.The inspection level takesα=0.05.(3)Multivariate logistic regression analysis,using the two classified logistic regression model to analyze the influencing factors of the elderly patients’visits and the influencing factors of the choice of medical institutions.The variables included in the filter included variables with statistically significant differences in the previous single Factor analysis(p<0.05),and the inclusion and exclusion criteria were0.10 and 0.05 respectively.The investigation process is strictly quality control,selected investigators need to have a serious and responsible characteristics and after a unified training,the survey used by the questionnaire has been unified development,and quality control in the investigation site was strictly implemented,the data are used double input method for input.Results:The number of elderly people in this study was 569,of which267(46.9%)were male,302(53.1%)were female,and sex ratio was1:1.13.The youngest of these people is 60 years old,the maximum age is109 years,the average age(71.60±9.04)years.The age composition is60-69 years old mostly,total 281(49.4%)people.Older men have more people in lower age than women.These seniors have 323(56.8%)people in Liwan,246(43.2%)in Yingde.The education level of 330(58.0%)people is elementary school and junior high school,among them male elder’s education level is higher than female.The marital status of the elderly is the majority of the spouses,a total of 419(73.6%)people,of which the majority of men,a total of 228(85.4%)people.Most of the elderly are insured for health insurance,with a total of 560 people(98.4%).The majority of elderly people’s homes are less than 1 km from the medical institutions,a total of 242(42.5%).Most of the elderly have a family income of less than 39999 yuan,a total of 209 people(36.7%).The prevalence of chronic diseases in the elderly is 57.8%,male is 51.7%,female is 63.2%,it is higher in females than in males(χ~2=7.764,P<0.05).The incidence of elderly people is 42.5%.The proportion of health status of"good"is the largest,a total of 350 people(61.5%).The rate of treatment for the elderly is 48%,and in men it is 41.9%,and in females it is 53.3%,women higher than men(χ~2=7.332,P<0.05).Factors that have a direct impact on whether or not to visit clinic were:family income,hypertension,diabetes,other chronic diseases,self-assessment of health status.The factors that have a moderating effect between hypertension and visits were gender,distance from medical institutions,diabetes,self-assessment of health status.The factors that have a mediating effect between hypertension and visits were gender,family income,diabetes,self-assessment of health status.Elderly people with high annual income were more likely to visit the hospital.Elderly patients with hypertension,diabetes,and other chronic diseases were more likely to see a doctor,and hypertension had the greatest influence on the visit.Older people with poor self-assessment of health status were more likely to see a doctor.The elderly patients with hypertension were more likely to go to hospital if they were female,higher education level,closer to medical institution,diabetes and poor self-assessment of health status.Factors that have a direct effect on the choice of medical institutions are:the distance between the place of residence and the medical institution(older people who are farther away are more likely to visit higher-level medical institution),annual household income(higher income have the possibility to visit higher-level medical institution),self-evaluation of health status(older people with poor self-assessment health status are more likely to visit the superior medical institutions),area(Liwan seniors are more likely to visit higher medical institutions),The factors that have a moderating effect in the relationship between family income and the level of medical institutions were:distance(older people with high incomes are more likely to attend a higher medical institution if they are far away from a medical institution).Conclusions:The prevalence of chronic diseases has the greatest effect on the elderly whether to see a doctor,the elderly with chronic diseases are more likely to see a doctor.The elderly patients with hypertension were more likely to go to hospital if they were female,higher education level,closer to medical institution,diabetes and poor self-assessment of health status.The family annual income has the greatest influence on the choice of medical institutions.The elderly with high household income are more likely to seek medical treatment at the higher level,while the elderly with low income tend to seek medical treatment at the primary level.Among the elderly with high income,those who are far away from medical institutions and those with poor self-assessment health are more likely to visit higher institutions.Compared with Liwan,the elderly in Yingde are more likely to go to primary-level medical institutions.In order to reduce the elderly attendance rate,promote the health of the elderly,so that the elderly can better use of health services,the need to proceed from the following aspects:strengthening the prevention of chronic diseases,reduce the treatment rate of the elderly population;do a good job of chronic disease management,promote the healthy aging of the elderly population,improve the income of low-income elderly groups. |
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