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目的了解苗族村寨农村留守老年人患病时门诊服务利用状况,分析其影响因素。方法 2011年7月选取贵州省黔东南苗族侗族自治州施秉县梨山坪、屯上、板屯3个苗族村寨112例≥60岁留守老年患者进行面访问卷调查,采用多元logistic逐步回归方法分析影响因素。结果留守老年人2周患者就诊率为47.3%(53/112),2周患者未就诊率为52.7%(59/112);53例农村留守老年人就诊地点为村卫生室占66.0%(35/53),乡镇卫生院及以上医疗机构占34.0%(18/53);候诊时间≥1 h占73.6%(39/53),<1 h占26.4%(14/53);医生在患者就诊时未告诉患者相关卫生保健知识占79.2%(42/53),告诉占20.8%(11/53);未向患者清晰解释病情占64.2%(34/53),清晰解释病情占35.8%(19/53);医生未很好地介绍治疗方案占52.8%(28/53),很好地介绍治疗方案者占47.2%(25/53);就诊满意占52.8%(28/53),不满意占47.2%(25/53);留守老年人患者不同说汉语能力、医疗单位距离、卫生保健知识、自感患病严重2周患者就诊情况比较,差异均有统计学意义(χ2=6.02、5.11、8.21、7.08,P<0.05或P<0.01);卫生保健知识(OR=4.13)、自感患病严重(OR=2.27)对门诊服务利用具有正向预测作用,医疗单位距离(OR=0.43)具有负向预测作用。结论留守老年人门诊服务利用程度较低,卫生保健知识、自感患病严重、医疗单位距离对门诊服务利用有影响。
Objective To understand the utilization of outpatient services in the elderly left behind in rural Miao villages and analyze the influencing factors. Methods In July 2011, 112 elderly patients aged ≥60 years old from Miaoshan Village, Lishanping, Tuen Shang and Banten Counties in Southe County, Guizhou Province, Miao and Dong Autonomous Prefecture of Guizhou Province were interviewed and investigated by multivariate logistic regression analysis Influencing factors. Results The attendance rate of left-behind elderly patients was 47.3% (53/112), 52.7% (59/112) in 2-week follow-up visits, and 66.0% / 53), township hospitals and above medical institutions accounted for 34.0% (18/53); waiting time 1 h accounted for 73.6% (39/53), <1 h accounted for 26.4% (14/53) 79.2% (42/53) did not tell the patient about the health care, accounting for 20.8% (11/53); they did not explain clearly to the patients 64.2% (34/53), 35.8% / 53). The doctors did not introduce 52.8% (28/53) of the treatment regimens well, 47.2% (25/53) introduced the regimen well, 52.8% (28/53) satisfied with the treatment, unsatisfied Accounting for 47.2% (25/53). There was a significant difference in left-behind elderly patients with different speaking Chinese proficiency, distance of medical units, knowledge of health care, and patients with severe self-esteem for 2 weeks (χ2 = 6.02, 5.11 , 8.21, 7.08, P <0.05 or P <0.01). Knowledge of health care (OR = 4.13), severe self-reported illness (OR = 2.27) had a positive predictive value for outpatient service utilization, ) Has a negative predictive effect. Conclusion The utilization of outpatient services for left-behind elderly patients is low, health care knowledge, self-reported illness and distance from medical units have an impact on outpatient service utilization.