Research On Prevalence Of Major Chronic Diseases,Burden Of Disease And Health Service Demand In Yuhua District

Objective:Through a prevalence survey of major chronic diseases and related risk factors,the burden of disease and the demand for health services in Yuhua District,to provide scientific basis on control the disease,control and reduce the burden of disease,allocate health resources rationally and improve the health of residents.Methods:Using a multi-stage isotactic cluster random sampling method in the first part,4113 residents aged over 18 years are extracted in Yuhua District,and the data are obtained through questionnaire investigation,physical examination and blood glucose measurement.Epidata 3.1 is used to carry out the questionnaire data.Statistical analysis,t test,Chi-square,variance analysis and multivariate logistic regression analysis are performed by Excel 2007 and SPSS 18.0.In the second part,the monitoring death data and the demographic data of the whole area are obtained through the "Population Death Information Registration and Management System".The data of the first part of the questionnaire are used to analyze the data of residents' burden of disease and health service demand through Excel 2007 and SPSS 18.0.Results:1.Prevalence and related risk factors of major chronic diseases(1)The top 10 chronic diseases are followed by hypertension(21.47%),diabetes(10.99%),coronary heart disease(3.57%),chronic obstructive pulmonary disease(1.56%),cerebrovascular disease(0.95%),diabetes mellitus(0.90%),Chronic gastroenteritis(0.90%),lumbar disc disease(0.83%),cervical disease(0.53%),hyperlipidemia(0.46%),gallstones and cholecystitis(0.44%)in Yuhua District.(2)The prevalence of hypertension(21.47%)is lower than the national average(25.2%);the prevalence of diabetes(10.99%)is higher than the national average(9.7%),and the prevalence of the two major chronic diseases increased gradually with age,and the highest prevalence in the60 years-old and above group.(3)The rate of overweight,obesity and central obesity are 28.2%,6.9%and 27.3% respectively.The male overweight rate is higher than that of female.(4)The smoking rate and alcohol consumption rate of the survey group are the highest in 35~44 years old group and 45~59 years old group;the proportion of male(20.99%)driving is significantly higher than that of female(9.00%);fruit and dairy products are inadequate.(5)The risk factors of hypertension are the middle-aged and elderly(45~59 years old group and 60 years-old and above group),overweight,obesity,central obesity,eating pig,beef or mutton for 1 to 2 days per week and eating chicken or duck for 5 to 7 days per week.(6)The risk factors of diabetes are young,the middle-aged and elderly(35~44 years old group,45~59 years old group and 60 years-old and above group),overweight,obesity,central obesity,eating fruits less than1 day per week,eating pig,beef or mutton less than 1 day per week and eating chicken or duck for 5 to 7 days per week.2.Residents' burden of disease,health service use and demand(1)The number of death caused by chronic diseases is the most in the death of Yuhua District in 2015,accounting for 89.93%;the first five causes of death are heart disease(1796),malignancy(1223),cerebrovascular disease(817),respiratory disease(677),endocrine nutrition and metabolic diseases(236).(2)The average life expectancy of people in Yuhua District is 75.55 years old,the life expectancy of men is 73.85 years old,and women is78.54 years old.The total death rate of PYLL in man is higher than in women(P <0.05);YLLs in men are higher than that in the same women years old group in all years old groups(P <0.05).(3)The rate of investigating residents' medical expenses account for 0 to2%(28.89%)of the total annual income is the highest,and the proportion of medical expenses account for 10%(25.59%)of the total annual income is the second.(4)In the survey population,the basic medical insurance for urban residents account for 27.77%,the basic medical insurance for urban workers account for 56.02%,the proportion of self-funded and othersocial health insurance account for 4.72% and 3.09%.(5)Two-week morbidity rate is 7.46%,two-week visiting rate is5.81%,and two-week leaving for sick rate is 1.19%.Two-week morbidity rate in 60 years-old group is the highest among the residents.75.42% of investigative people there are clinics or hospitals within one kilometer distance,and the proportion of residents preferred to community health service centers / township hospitals is 45.61%.(6)The channels for obtain chronic diseases care information are mainly obtained through leaflets(65.43%),outdoor billboards(62.80%)and television stations(55.53%).The proportion of lectures(46.58%)is less than 50%.(7)Residents' demand for community health services is mainly focused on regular physical examination(94.85%).Conclusion:The prevalence of chronic diseases in residents aged over 18 in Yuhua District of Changsha City is mainly in hypertension and diabetes.The 35~44 years old group and 45~59 years old group,the overweight,obesity and central obesity are the prevention and treatment objects of chronic diseases in Yuhua District.The death number of chronic is the major part of all causes of death.The life expectancy of Yuhua residents in 2015 is 75.55 years,which is lower than the average life expectancy of China.The proportion of PYLL and YLLs in the male population is significantly higher than that in the female population,andthe measures of prevention and intervention of male patients should be increased.There is a contradiction between the need for health investment and the serious burden of medical expenses.Two-week morbidity rate and two-week visiting rate are lower than that of the fifth national health service survey.The community health service center / township health center is selected after the illness and the demand for community health service is mainly focus on regular physical examination.Therefore,we should make more health resources flow to the primary health care institutions and the field of prevention and basic public health services,and implement a model of community-centered,prevention first,prevention and treatment of mutual integration.According to the characteristics of the crowd,rational allocation of health resources and basic public health services,and prevent chronic diseases actively.