西部地区农村居民两周患病未就诊影响因素研究
Influencing Factors of Non-treatment-seeking Behaviors for Perceived Morbidity within Two Weeks among Rural Residents in Western China
背景 近年来，卫生服务研究成为我国卫生事业的重要研究领域。既往研究多针对居民两周患病、两周就诊情况及其相关影响因素进行分析，而作为负向指标的两周患病未就诊研究较为少见。目的 了解农村居民两周患病未就诊现状，对其影响因素进行探讨并分析原因，从而提出针对性建议。方法 于 2019 年 12 月，由 82 名调查员采取多阶段分层整群随机抽样方法，抽取宁夏回族自治区农村地区 4 县 27 196 例居民，采用自制调查问卷展开两周患病情况的问卷调查。问卷内容包括居民的人口学特征、居民的健康特征及医疗卫生服务可得性和可及性，根据调查结果构建两周患病未就诊情况的结构方程模型，分析其影响因素并进行检验。结果 本研究共收集问卷27 196 份，有效问卷 21 451 份，有效回收率为 78.88%。宁夏农村地区居民两周患病率为 14.97%（3 212/21 451），两周就诊率为 4.57%（981/21 451），两周患病未就诊率为 69.46%（2 231/3 212）。不同性别、年龄、受教育程度、职业、自评健康状况、是否患有慢性病、两周患病卧床天数及到二级及以上医疗机构时间的居民两周患病未就诊情况比较，差异均有统计学意义（ P<0.05）。结构方程模型拟合结果显示，人口学特征对居民两周患病未就诊情况影响的总效应为 -0.101（ β =0.110），其中直接效应为 0.107，间接效应为 -0.208；健康特征对居民两周患病未就诊情况影响为直接效应，总效应为 -0.210（ β =-0.313） 。结论 宁夏回族自治区农村地区居民两周患病未就诊率较高且居民健康特征对两周患病未就诊影响较大，说明该地区居民的主动健康意识较差，应针对其影响因素，采取相应措施、制定相关政策从而优化医疗卫生资源配置，提高该地区卫生服务利用水平。
BackgroundHealth service research has become an important research field in health industry of China recently. Existing studies mainly focus on the prevalence of perceived morbidity within two weeks and associated treatment-seeking behaviors as well as influencing factors in residentsbut rarely involve in their non-treatment-seeking behaviors. ObjectiveTo understand the prevalence of non-treatment-seeking behaviors in rural residents with perceived morbidity within two weeksand to explore and analyze the influencing factorsso as to put forward targeted suggestions. Methods In December 2019by use of a multistage stratified cluster random sampling approach27 196 residents from four rural counties of Ningxia Hui Autonomous Region were selected by 82 investigators to attend an interviewer-administeredface-to-face survey using a selfdeveloped Two-week Morbidity Questionnaire for understanding their demographicshealth characteristicsand the availability and accessibility of medical and health services. A structural equation model built based on the survey results was used to analyze and test the influencing factors of non-treatment-seeking behaviors for two-week morbidity. Results Of the residents21 45178.88%who effectively responded to the survey were included for analysis. The two-week morbidity in the respondents was 14.97%3 212/21 451and the prevalence of non-treatment-seeking behaviors was 69.46%2 231/3 212. The prevalence of non-treatment-seeking behaviors for two-week morbidity varied by genderageeducation leveloccupationself-assessed health statusprevalence of chronic diseasesthe number of days of bed rest for an illnessand the time to go to secondary or higher medical institutions P<0.05. The fitting outcome of the structural equation model showed that the total effect of demographics on non-treatment-seeking behaviors was -0.101 β =0.110of which the direct effect was 0.107and the indirect effect was -0.208. Health characteristics had a direct effect on non-treatment-seeking behaviors with a total effect of -0.210 β =-0.313. Conclusion The prevalence of non-treatment-seeking behaviors is relatively high in Ningxia rural residentswhich is greatly affected by the health characteristicsindicating that they have a poor awareness of proactive health. It is suggested to take measures and formulate relevant policies according to the influencing factors to optimize the allocation of medical and health resourcesso as to improve the utilization level of health services in this region.
乔慧 、李培雯、马喜民、贺嘉慧
医药卫生理论医学研究方法预防医学
卫生服务患病率两周患病未就诊影响因素分析结构方程模型宁夏回族自治区
Health servicesPrevalencewo-week prevalence of not visiting a doctornalysis of influencing factorsStructural equation modelNingxia
乔慧 ,李培雯,马喜民,贺嘉慧.西部地区农村居民两周患病未就诊影响因素研究[EB/OL].(2023-03-03)[2025-08-02].https://chinaxiv.org/abs/202303.00015.点此复制
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