农村流入人口医疗卫生服务利用现状及影响因素分析

目的 通过分析农村流入人口医疗卫生服务利用的现状，探究影响其医疗卫生服务利用的因素，为改进农村流动人口医疗卫生服务提出建议。 方法 筛选2017年全国流动人口卫生计生动态监测调查数据中流入农村的流动人口39 578例，分析农村流入人口医疗卫生服务利用的现状，并利用多因素logistic回归分析影响农村流入人口医疗卫生服务利用的因素。 结果 18 922例最近一年有患病或身体不适的流入农村人口中，10 705例曾就诊，就诊率为56.6%；首诊机构为本地社区卫生站和本地个体诊所的分别占24.5%和18.8%；听说过国家基本公共卫生服务项目（OR = 1.127，95%CI:1.055～1.204）、已建立健康档案（OR = 1.240，95%CI:1.148～1.340）、接受过健康教育（OR = 1.224，95%CI:1.146～1.308）、有医保（OR = 1.128，95%CI:1.003～1.268）的农村流入人口医疗卫生服务利用率高；而有工作的（OR = 0.803，95%CI:0.733～0.880）、随家属迁移的（OR = 0.851，95%CI:0.729～0.994）、自评健康状况健康（OR = 0.514，95%CI:0.444～0.595）的农村流入人口卫生服务利用率较低。 结论 流入农村人口医疗卫生服务利用情况较差；患病后首诊机构多为本地社区卫生站和本地个体诊所；流动原因、就业状况、自评健康状况、健康档案建立情况、健康教育接受情况、是否听说过国家基本公共卫生服务项目以及是否有医保均会影响农村流入人口利用医疗卫生服务。

Analysis of the current situation and influencing factors of medical and health service utilization of flowing population into rural areas

Objective To analyze the current situation of health service utilization of flowing population into rural areas, explore the factors affecting their health service utilization, and give suggestions on improving health services for them. Methods A total of 39 578 mobile people flowing into rural areas were selected in the 2017 national mobile population health and family planning dynamic monitoring survey data. The current situation of health service utilization of rural inflow population was analyzed, and the factors influencing the utilization of health services of rural inflow population was analyzed using multi-factor logistic regression. Results Among 18 922 mobile people of rural inflow with illness or discomfort in the recent year, 10 705 people sought medical consultation, and the consultation rate was 56.6%; 24.5% and 18.8% of the first consultation institutions were local community health stations and local individual clinics, respectively; those who heard of the national basic public health service program (OR=1.127, 95%CI: 1.055-1.204), established health records (OR=1.240, 95%CI: 1.148-1.340), received health education (OR=1.224, 95%CI: 1.146-1.308), and had medical insurance (OR=1.128, 95%CI: 1.003-1.268) had higher utilization of health services; while those who had a job (OR= 0.803, 95%CI: 0.733-0.880), those who migrated with their families (OR=0.851, 95%CI: 0.729-0.994), and those with a healthy self-rated health status (OR=0.514, 95%CI: 0.444-0.595) had a lower utilization of health services among the rural inflow. Conclusion The utilization of health services among the rural inflow population is poor, and the first consultation institutions after illness are mostly local community health stations and local individual clinics. The reasons of mobility, employment status, self-assessed health status, health record establishment, health education acceptance, whether they hear of the national basic public health service program, and whether they have medical insurance are influencing factors of the utilization of health services among the rural inflow population.