| Objective:Through the study on health services utilization of Hangzhou residents,we can understand health services utilization level. Analyze the current allocation of health resources, and find the existence problems and weak links, in order to optimize the allocation of health resources, put forward policy suggestions to improve the residents’health service fairness, so as to improve people’s health and develop health career.Methods:A questionnaire survey of health services utilization was used to choose residents from15districts in Hangzhou. Cluster random sampling method was carried out in this survey. Choose urban community residents, employees and enterprise employees in urban districts, then choose urban community residents, rural community residents, employees and enterprise employees in rural districts, a total of2488residents was surveyed by questionnaire. Collected health resources data and health related indicators from2007to2011in Hangzhou. Using the Lorenz curve and Gini coefficient to analysis equity of health resources.Using the Concentration index(CI) to analysis the health service utilization.Results:(1) The overall health level of Hangzhou residents increased year by year, but there is still have a high trend of prevalence rate about chronic diseases such as hypertension and diabetes. The standardized management of hypertension patients only account for50.11%and36.11%of the predicted number.(2) Two-week prevalence was12.6%, chronic disease prevalence was29.7%, health literacy rate is only9.2%. the health services need between urban and rural residents are the same.(3) Two-week unvisting rate was59.1%, the self-medication rate was39.2%, outpatient health service utilization level is not high. The hospitalization rate was10%, without hospitalization rate was10.3%, health services utilization in hospital is better. The logistic regression analysis shows that the cultural level, age, income, two-week prevalence and chronic disease prevalence affecting health service utilization.(4)49.1%urban residents preferred provincial hospitals for medical treatment, but49.5%local residents preferred the county level hospital. The proportion of first option of community health service institutions (45.8%) is better than that of residents (24.8%), the distance is the main reason.(5)The equity of health resources in Hangzhou is not bad, the Gini coefficient of hospitals, beds and doctors according to the population distribution are0.08,0.32and0.46.However, the Gini coefficient is over0.6, the equity of health resources with high quality is relatively poor.(6) The equity of outpatient health services utilization is well. The CI of hospitalization rate is less than zero, inpatient health service utilization tend to high income people. CI show that the equity of outpatient health services utilization is superior to inpatient health service utilization.Conclusion:(1)Overall health level of Hangzhou residents is raised, health services demand of chronic disease management is big. It is suggested to improve the standardized management of chronic diseases and focus on comprehensive intervention for major risk factors.(2)The health services need between urban and rural residents have consistent level. But the distribution of health service resources especially high quality health service resources is unfair. Government should adjust the health resource distribution, while increasing medical service ability in county hospital, so that county residents will have access to high-quality health resources.(3) Consummate the construction of medical institutions, and improve the ability of basic health services. Carry out the referral system to guide the patient have a reasonable choice, so as to promote reasonable utilization of outpatient and inpatient health services.(4) Important factor of health service utilization is income, educational level. Health policy should focus on low-income groups. At the same time, through health education to form a health habit and improve the health literacy. |
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