| Objective:To analyze the current situation and influencing factors of the health service utilization for the elderly with chronic comorbidity,guide the elderly to use timely and effective health service utilization,improve the level of health services utilization for the elderly with chronic comorbidity,reasonably use medical resources,and provide effective suggestions and reference for the prevention and control of chronic comorbidity among the elderly and improving the quality of life of the elderly with chronic comorbidity.Methods:This study was a cross-sectional study on questionnaire survey and physical examination of rural elderly aged 60 and above in Luoping County,Yunnan Province.Multi-stage stratified random sampling method was used to investigate the survey population.The research contents mainly included the health services needs and utilization of the population,as well as the main demographic characteristics and lifestyles.SPSS26.0 software was used for quantitative statistical analysis of the data.The average,standard deviation,frequency,constituent ratio and other statistical indicators were used to describe the general demographic data,lifestyle characteristics,chronic diseases and health services utilization of the elderly population surveyed in Luoping County,Yunnan Province.Chi square test and Logistic regression model were used to analyze the impact of chronic comorbidity on the health services utilization of the elderly.The association rule analysis method based on Apriori algorithm was used to explore the pattern of chronic disease comorbidity among the elderly in Luoping County,Yunnan Province.T-test was used to compare the mean of the two groups of samples;Comparison between two or more groups of data classified byχ~2test.All statistical tests were bilateral tests,and the test level wasα=0.05,P<0.05 was considered statistically significant.Results:962 elderly people aged 60 and above in Luoping County,Yunnan Province participated in this study,the two-week disease prevalence rate of the elderly in this survey was 42.9%.The prevalence of chronic diseases among the elderly in the survey area was 67.5%,the prevalence of one chronic disease was 45.5%,and the prevalence of chronic comorbidity was 22.0%.In this survey,among 962 elderly people,the two-week visiting rate was 28.8%,the two-week consulation visit rate was 67.1%,the utilization rate of outpatient services with chronic diseases in one year was 20.6%,and the hospitalization rate in the past year was 29.2%.Among the elderly with chronic comorbidity,the two-week visiting rate was 32.1%,the two-week consulation rate was 64.8%,the utilization rate of outpatient services with chronic diseases in one year was 38.7%,and the hospitalization rate in the past year was 40.6%.In the survey population,the general health score and mental health score of the elderly were 51.98±7.13 and 59.82±8.21.The result of binary logistic regression analysis in this study showed that among predisposing factors,age group and whether farmers were related to health services utilization for the elderly aged 60 and above in Luoping County,Yunnan Province(P<0.05).Among the enabling resources,family income per capita and insurance participation were related to health services utilization for the elderly aged 60 and above in Luoping County,Yunnan Province(P<0.05).Among the demand factors,self-rated health and the number of chronic diseases were related to health services utilization for the elderly aged 60 and above in Luoping County,Yunnan Province(P<0.05).Among the lifestyle,drinking,sleeping and regular physical activity and physical labor intensity were related to health services utilization for the elderly aged60 and above in Luoping County,Yunnan Province(P<0.05).Among predisposing factors,age group was related to health services utilization for the elderly aged 60years and above with chronic comorbidity in Luoping County,Yunnan Province(P<0.05).The influence of enabling resource factors on health services utilization was not statistically significant(all P>0.05)among the elderly aged 60 and above with chronic comorbidity in Luoping County,Yunnan Province.Among the demand factors,the number of chronic diseases and self-rated health were related to health services utilization for the elderly aged 60 and above with chronic comorbidity in Luoping County,Yunnan Province(P<0.05).Among the lifestyle,whether drinking alcohol and taking salted products were related to health services utilization for the elderly aged 60 and above with chronic comorbidity in Luoping County,Yunnan Province(P<0.05).Conclusion:The prevalence of chronic diseases was high among the elderly aged60 and above and the people with chronic comorbidity in Luoping County,Yunnan Province.The top five chronic diseases were hypertension,COPD,diabetes,hyperlipidemia and stroke.The comorbidities of chronic diseases in the elderly were diverse in Luoping County,Yunnan Province.The health services needs of the elderly aged 60 and above and the people with chronic comorbidity were high in Luoping County,Yunnan Province,however,the health services utilization level was low,and the overall health status of the elderly aged 60 and above in Luoping County,Yunnan Province was poor,local government should pay attention to the quality of life among the elderly.Demand factors(number of chronic diseases and self-rated health)were strong predictors that affect the health services utilization in the elderly aged 60 and above and the elderly with chronic comorbidity in Luoping County,Yunnan Province,which should be focused on.Suggestions:(1)Strengthen the health education on chronic diseases among the elderly,and focus on the elderly with chronic comorbidity;(2)Formulate corresponding health care policies to meet the health service needs of the elderly with chronic comorbidity;(3)Take targeted measures to improve the utilization level of health services among with chronic comorbidity;(4)Improve the level of chronic disease monitoring and self-management of elderly people with chronic comorbidity. |
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