Current status of health service utilization and its influencing factors amongmiddle-aged and elderly patients with chronic non-communicable diseases in China
LI Shu-feng1, YAN Xiao-ling1, FU Han-lin2, BIE Feng-sai1, WANG Qing1, WEN Hai1
1.Institute of Medical Information, Peking Union Medical College/Chinese Academy of Medical Sciences, Beijing 100020, China; 2. School of Xiangya Public Health, Central South University, Changsha, Hunan 410078, China
Abstract:Objective To analyze the current status and influencing factors of health services utilization among middle-aged and elderly patients in China, and to provide references for improving health service utilization. Methods A total of 6,952 middle-aged and elderly patients with chronic diseases were extracted from the database of China Health and Retirement Longitudinal Study conducted in 2015. Statistical description, χ2-test and multivariate logistic regression were performed to analyze the current status of health services utilization and its influencing factors. Results The four-week outpatient rate in the middle-aged and elderly patients with chronic diseases was 24.14%, and the one-year hospitalization rate was 17.69%. Multivariate logistic regression analysis indicated that gender (reference: female, male OR=0.79, 95%CI:0.70-0.88), self-rated health status (reference: poor, excellent OR=0.31, 95%CI:0.21-0.46; good OR=0.37, 95%CI:0.28-0.49; middle OR=0.55, 95%CI:0.47-0.64; somewhat poor OR=0.66, 95%CI:0.57-0.76), depression status (reference: poor, excellent OR=0.55, 95%CI:0.45-0.67; middle OR=0.73, 95%CI:0.60-0.90) and household income (reference: low, medium OR=1.20, 95%CI:1.05-1.37;high income OR=1.49, 95%CI:1.19-1.87) were the factors influencing the four-week outpatient rate. Residence (reference: rural area, urban area OR=1.42, 95%CI:1.17-1.72; suburb area OR=1.34, 95%CI:1.12-1.61), age (reference: 45- years old, 50- years old OR=1.10, 95%CI:0.89-1.35; 60- years old OR=1.41, 95%CI:1.15-1.73; 70- years old OR=1.79, 95%CI:1.44-2.22), education background (reference: elementary school or below, middle school OR=1.15, 95%CI:0.98-1.35; high school OR=1.31, 95%CI:1.06-1.63; college degree or above OR=0.90, 95%CI:0.61-1.33), self-rated health status (reference: poor, excellent OR=0.27, 95%CI:0.17-0.42; good OR=0.20, 95%CI:0.14-0.28; middle OR=0.32, 95%CI:0.27-0.39; somewhat poor OR=0.47, 95%CI:0.40-0.55), depression status (reference: poor, excellent OR=0.73, 95%CI:0.58-0.93; middle OR=0.89, 95%CI:0.70-1.12), health service satisfaction (reference: very unsatisfactory, very satisfactory OR=1.61, 95%CI:1.20-2.15; somewhat satisfactory OR=1.59, 95%CI:1.22-2.07; neutral OR=1.24, 95%CI:0.96-1.60; somewhat unsatisfactory OR=1.28, 95%CI:0.96-1.70), physical function status (reference: no difficulty, some difficulties OR=0.47, 95%CI:0.24-0.93; difficulty OR=0.81, 95%CI:0.40-1.64) were the factors influencing the one-year hospitalization rate. Conclusions The level of health services utilization of middle-aged and elderly patients with chronic non-communicable diseases in China is generally high, but there are differences among variables such as gender, residence, age, education background,self-rated health status, depression status, health services satisfaction, physical function status and total household income. Primary health care facilities should carry out health education, psychological counseling and rehabilitation training for the middle-aged and elderly patients, and pay more attention to the status of medical check-up and hospitalization in male and less-educated patients. The authorities should push forward the urbanization, increase the income of residents and optimize the medical environment.
李树峰, 严晓玲, 付翰林, 别凤赛, 王晴, 闻海. 我国中老年慢性病患者卫生服务利用现况及影响因素分析[J]. 实用预防医学, 2019, 26(5): 550-554.
LI Shu-feng, YAN Xiao-ling, FU Han-lin, BIE Feng-sai, WANG Qing, WEN Hai. Current status of health service utilization and its influencing factors amongmiddle-aged and elderly patients with chronic non-communicable diseases in China. , 2019, 26(5): 550-554.