上海市外来务工人员卫生服务需求和利用现状调查研究

摘要

[AbstraCt] ObjeCtive Find out the condition of the health service demands and utilization of migrant workers in Shanghai and provide an objective evidence for the development of health planning, policy and evaluation of health reform. Methods 5 855 migrants in seven administrative region of Shanghai( Xuhui,Putuo,Changning,Yangpu,Pudong, Jiading,Qingpu)were investigated by the questionnaire survey with multistage system sampling method from July to September in 2012. The content of survey included demographic characteristics,living status,health status,health service demands and utilization,etc. Sended out 5 855 questionnaires,recycled 5 855,excluded 57 questionnaire with a lot of missing item. Eventual effective questionnaires 5 798,effectiveness was 99. 0% . Statistical methods included descriptive analysis,chi _ square test, rank sum test and binary logistic regression analysis. Results Two _ week prevalence rate of migrant workers was 14. 7% (851 /5 798),health insurance coverage was 75. 7% (4 391 / 5 798),two _ week attendance rate was 7. 8% (455 / 5 798),one _year rates of hespitalization was 3. 5% (205 / 5 798),two _ week non _ attendance rate of patients was 46. 5% (396 / 851). Self _ rated health was related to two _ week prevalence rate of migrant workers,self _ rated health and medical insurance in hometown was related with two _ week attendance rate of migrant workers,resident condition were related with two _ week non _ attendancerate of migrant workers. ConClusion Two _ weeks attendance rate of migrant workers is low,two _ week non _ attendancerate is high. General practice should be developed rapidly,health education for migrant workers should be strengthened,the government should guide them to make use of community health services effectively and improve the rate of their community health services utilization.%目的：了解上海市外来务工人员的卫生服务需求和利用现状，为卫生规划和卫生改革政策的制定提供客观依据。方法于2012年7—9月，采用多级系统抽样方法，对上海市七个行政区（徐汇、普陀、长宁、杨浦、浦东、嘉定、青浦）的5855名外来务工人员进行问卷调查，调查内容包括人口学特征、居住状况、健康状况、卫生服务需求及利用情况等。发放问卷5855份，回收5855份，剔除57份缺项较多的问卷，最终有效问卷数为5798份，回收有效率为99.0%。结果上海市外来务工人员两周患病率为14.7%（851/5798），医疗保险的覆盖率为75.7%（4391/5798），两周就诊率为7.8%（455/5798），一年住院率为3.5%（205/5798），两周患者未就诊率为46.5%（396/851）。上海市外来务工人员两周患病率的相关因素为自评健康状况，两周就诊率的相关因素为自评健康状况和户籍地医保种类，两周患者未就诊率的相关因素为居住状况。结论上海市外来务工人员健康状况较好但卫生服务利用情况较差，应大力发展全科医疗，加强对外来务工人员的健康教育，引导其合理有效地利用社区卫生服务，提高其社区卫生服务利用率。