流动人口背景下欠发达地区农村妇女住院医疗服务及影响因素分析

谢飞; 陈晨; 潘冰冰; 文小桐; 张连军; 郑辉烈; 汪金福; 袁兆康

doi:10.11847/zgggws1119451

流动人口背景下欠发达地区农村妇女住院医疗服务及影响因素分析

Utilization and influencing factors of hospitalization service among the all, migrant and home-dwelling rural women aged 15 years and above in less-developed areas of Jiangxi province: a tracking survey

摘要

摘要:
目的从全体，外出及常住三方面对比分析妇女住院医疗服务卫生问题，并分析其住院率的影响因素，为欠发达地区农村妇女住院医疗卫生服务的改进提供科学依据。
方法采用多阶段分层整群随机抽样方法，于2006、2008、2010、2012、2014年在江西省婺源县、芦溪县、修水县对在本地居住半年以上的农村居民以及户口在本地的外出务工人群进行入户调查，选取其中≥15岁妇女为研究对象，5年分别调查3 347、3 285、2 923、3 051、2 994名农村妇女，运用复杂抽样logistic回归进行危险因素分析。
结果总体，常住及外出妇女住院率均呈逐年上升趋势，其中总体妇女住院率由2006年的5.46 %增加至2014年的9.34 %，除2006年外，其他各年份常住妇女住院率均高于外出人群。外出妇女慢性病患病率为2.80 %，远低于常住妇女的14.50 %，2012及2014年常住妇女住院率分别为8.29 %、10.93 %，高于外出妇女住院率的1.92 %、5.94 %（χ² = 137.996、23.641，均P < 0.05）；已婚常住妇女住院率为8.24 %，高于外出妇女的6.50 %（χ² = 5.334，P = 0.040）。复杂抽样logistic回归分析结果显示，35～54岁妇女住院概率低于15～34岁妇女；未婚妇女住院概率低于离婚或丧偶妇女，已婚妇女住院概率更高；相对于高收入水平妇女，中等收入水平妇女住院概率更低；劳动力妇女住院概率更低；慢性病是妇女住院的危险因素。
结论欠发达农村地区妇女住院服务需求与利用逐步释放，常住妇女的卫生医疗资源应更倾向于老年人住院疾病；全面实行全人群慢性病防治、加强妇女文化教育、提高其收入水平，可有效增加其必要的住院服务利用。

Abstract:
Objective To analyze the changing trend in hospitalization rate and its influencing factors among the all, migrant, and home-dwelling rural women and to provide evidences for improving hospitalization service to rural women in less-developed areas.
Methods Using stratified multistage random cluster sampling, we conducted household questionnaire surveys among 3 347, 3 285, 2 923, 3 051, and 2 994 permanent female residents ≥ 15 years old in less-developed rural areas of Wuyuan, Luxi and Xiushui county of Jiangxi province in 2006, 2008, 2010, 2012, and 2014, respectively. Complex sampling logistic regression was used to analyze influencing factors for utilization of hospitalization in the women.
Results The hospitalization rate increased among the all, migrant, and home-dwelling rural women during the period and for all the women, the rate rose from 5.46% in 2006 to 9.34% in 2014. Compared to the migrant women, the home-dwelling women had higher annual hospitalization rate in the study period, except in the year of 2006. The prevalence rate of chronic diseases was 2.80% in the migrant woman and the rate was much lower than that in the home-dwelling women (14.50%). In contrast to the migrant women, the home-dwelling women had significantly higher hospitalization rate in 2012 (8.29% vs. 1.92%, χ² = 137.996) and in 2014 (10.93% vs. 5.94%, χ² = 123.641)(both P < 0.05). The hospitalization rate in the married home-dwelling women was 8.24% and significantly higher than that (6.50%) in the migrant women (χ² = 5.334, P = 0.040). Complex sample logistic regression analyses revealed that the women aged 35 – 54 years, being unmarried, with middle income, and with ability to work were more likely to have a lower hospitalization rate in comparison to those aged 15 – 34 years, with higher income, being married/divorced/widowed, and being unable to work. Having chronic disease was a major risk factor for hospitalization for all the women.
Conclusion Both the demand and utilization of hospitalization increased among adult women, especially among home-dwelling elderly women, in less-developed rural areas of Jiangxi province during the period from 2005 to 2014, suggesting that measures should be taken to promote utilization of hospitalization service in the population.

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