流动老人基本公共卫生服务利用及影响因素研究

目的:了解流动老人基本公共卫生服务利用情况及其影响因素,为促进公共卫生服务均等化提供数据支持。方法:以安德森卫生服务利用模型为理论基础,使用2015年全国流动人口动态监测数据,结合深度访谈,对影响流动老人卫生服务利用的人群特征及环境因素进行分析。结果:流动老人基本公共卫生服务利用率偏低并在群体内存在差异;户籍类型、居住时长、流动范围是影响流动老人卫生服务利用的主要因素;基层卫生服务机构存在经费拨付与工作量不一致、数据不清、工作不被理解等方面的困难。结论:流动老人基本公共卫生服务可及性较差、健康意识薄弱,应加强健康教育宣传;对农村户籍、居住时间短和流动跨度大的老人给予重点关注;卫生部门应加强针对流动老人的数据统计,改变基本公共卫生服务经费拨付方式,优化信息化建设顶层设计,促进流动老人基本公共卫生服务利用。

Influencing factors of basic public health service utilization of the migrant elderly

Objective:The aim of this study is to explore the utilization of basic public health services by elderly migrants and its influencing factors, and to provide data support for the equalization of public health services. Methods:The framework of the Behavioral Model of Health Services Utilization elaborated by Anderson was used as the theoretical basis. Basing on the data of 2015 National Dynamic Monitoring of Mobile Population, the multivariate logistic regression model was used to analyze the materials coming from in-depth interviews. Results:The utilization rate of basic public health services by the elderly migrant was low and there are differences as compared to other groups. The type of household registration, living duration and the scope of mobility were the main factors influencing the utilization of health services by the elderly migrants. The allocation of funds to primary health care services is inconsistent with the workload, and other difficulties for the community service agencies. Conclusions:The accessibility of basic public health services for the elderly migrants is poor, the health consciousness is weak, and health education should be strengthened. The elderly migrants coming from rural areas, having long-term residence and migrating long distance should be paid more attention too. The administrative departments should strengthen the statistics on elderly migrants, ensure a fair allocation of funds for the basic public health service, and optimize the top-level design of information technology to improve the use of the basic public health services for elderly migrants.