| 引用本文：郭静, 邵飞, 范慧, 薛丽萍, 吴亚琴.流动人口基本公共卫生服务可及性及影响因素分析[J].中国卫生政策研究,2016,9(8):75-82 |
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| 流动人口基本公共卫生服务可及性及影响因素分析 |
| 投稿时间：2016-01-20 修订日期：2016-05-08 PDF全文浏览 HTML全文浏览 |
| 郭静, 邵飞, 范慧, 薛丽萍, 吴亚琴 |
| 中国人民大学社会与人口学院 北京 100872 |
| 摘要:目的:了解流动人口基本公共卫生服务可及性及其影响因素。方法: 以安德森卫生服务利用模型为理论基础，使用“流动人口卫生计生服务流出地监测调查（2014）”数据，采用多水平Logistic回归模型从宏观和微观两个层面，对流动人口基本公共卫生服务可及性及影响因素进行分析。结果：流动人口基本公共卫生服务利用率偏低，其在流出地和流入地均有卫生服务需求；对于全人群适用的健康档案、健康教育和健康体检服务项目的利用，流动人口群体内部存在差异；在同一调查点，流动人口卫生服务利用存在组内聚集性，多水平logistic回归分析发现经济社会发展水平、流出地卫生资源配置水平这两个宏观因素和流动人口的性别、年龄、受教育程度、医疗保险参保情况、流动范围及就业单位性质等个体微观因素，是影响流动人口基本公共卫生服务可及性的主要因素；不同服务项目的影响因素既有共性又有差异。结论：流动人口基本公共卫生服务可及性较差，应强化健康教育和引导干预；不同服务项目利用水平存在差异，应重点关注全人群适用项目和慢性非传染病管理；宏观环境因素和微观个体因素对服务可及性均存在影响，因此在增加服务供给的同时还应从流动人口特征着手，提高其主动性和参与意愿；不同性质就业单位中的流动人口卫生服务利用情况不同，应考虑单位及职业特征对服务利用的影响。 |
| 关键词:流动人口 基本公共卫生服务 可及性 影响因素 |
| 基金项目:中国人民大学科学研究基金（中央高校基本科研业务费专项）（16XNB027） |
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| Analysis on the access to the basic public health care services and influencing factors among migrants |
| GUO Jing, SHAO Fei, FAN Hui, XUE Li-ping, WU Ya-qin |
| School of Sociology and Population Study, Renmin University of China, Beijing 100872, China |
| Abstract:Objective: To study the access to basic health services and its influencing factors among migrants and to provide proposals on promoting the healthcare services equity. Methods: The framework of the Behavioral Model of Health Services Utilization elaborated by Anderson was used as a theoretical basis, data from the “2014 Basic Health Services for Migrants Monitoring Survey” conducted by NHFPC in Outflow Areas was used. The multilevel logistic regression model was used to analyze the access to the basic health care services and its influencing factors among migrants both in macro and micro levels. Results: The sample consisted of 5812 subjects and it was proved to be at a low level the health service utilization among migrants since health services demands appeared in both outflow and inflow areas. There were differences among internal floating population for the use of medical services, health education and health records. There was intra-class clustering for the access to health services in the same survey field, the Multilevel logistic regression analysis indicated that the macroeconomic factors of accessibility were the economic and social development level, the level of medical resources allocation in outflow areas and migrants gender, age, educational level, medical insurance status, the flow range and the nature of self employment characteristics. The main factors influencing the flow of population to different basic health services and property have both commonalities and differences. Conclusions: The access to basic public health services among migrants is poor and Health education and guidance interventions should be strengthened. There are differences in different services utilization levels, and the services apply to whole populations and the project management of chronic non-communicable diseases services should be applied. Both the macro environmental factors and micro or individual factors do have effect on the access. Therefore an increase in supply of services should also proceed based on the floating population characteristics, activity and attention to the basic public health care services while improving their initiative and willingness to participate. Finally, the impacts that different work units and occupational characteristics of the population have on the basic public health care services utilization should also be taken into consideration. |
| Key words:Migrants Access to the basic public health care services Influencing factors Multilevel logistic regression model |
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