| Objective:To understand the current status,knowledge and satisfaction of the use of Essential Public Health Services(hereinafter referred to as EPHS)by the elderly in Kunming,to discuss the influencing factors of the use of EPHS by the elderly,to propose strategies and suggestions,and to further improve the use of EPHS The level provides the basis.Methods:A multi-stage sampling method is adopted,and a self-made questionnaire is used for household surveys.That is,among the 10 streets in Chenggong District,8 streets are randomly selected,each street is randomly selected from 2 village committees/community neighborhood committees,each village committee/community neighborhood committee is randomly selected from not less than 30 objects.Select the elderly who have lived in Chenggong District for more than half a year and are 65 years of age or older as the target of the survey.The survey includes four aspects:the utilized situations,knowledge and satisfaction of the elderly on the use of services.Epidata 3.1 was used for data entry,SPSS 21.0 was used for data analysis,chi-square test and rank sum test was used for single factor analysis,and Logistic regression was used for multi-factor analysis.Results:1.In this survey,a total of 560 questionnaires were distributed and 560 questionnaires were returned,with a recovery rate of 100%.550 valid questionnaires,the effective rate is 98%.The average age of the elderly is(72.56±6.54)years old;among them,there are 323 women,accounting for 58.72%;501 agricultural workers,accounting for 91.09%;and 367 with spouses,accounting for 66.73%.2.The utilization rate of EPHS for ordinary elderly people is:lifestyle and health assessment 59.00%,physical examination 84.10%,auxiliary examination 83.68%,health guidance 84.52%;hypertension/diabetes elderly the utilization rates of various EPHS are:lifestyle and health assessment 52.09%,physical examination 76.85%,auxiliary examination 73.95%,health guidance 74.60%.Ordinary elderly and hypertension/diabetic elderly have a lower utilization rate of lifestyle and health assessment than 81.50%in Tangshan[1](χ2=28.918,P=0.000;χ2=51.199,P=0.000);ordinary elderly and The utilization rate of physical examination of hypertension/diabetes elderly was 79.30%of Tangshan[1],the difference was not statistically significant(χ2=2.001,P=0.157;χ2=0.551,P=0.458);ordinary elderly and hypertension/the utilization rate of health guidance by the elderly with diabetes is higher than that of Tangshan 66.8%[1],and the difference is statistically significant(χ2=20.327,P=0.000;χ2=3.993,P=0.046).Comparison of the use of EPHS among ordinary elderly people and those with hypertension/diabetes:except for no statistical difference in lifestyle and health assessment(P>0.05),the utilization rate of ordinary elderly people for physical examination,auxiliary examination and health guidance are all higher than the elderly with hypertension/diabetes,there were statistical differences(P<0.05).3.The awareness rates of various EPHS of the elderly are:listyle and health assessment is 65.09%,lower than Chongqing’s 89.20%[2](χ2=71.122,P=0.000);physical examination is 95.82%,auxiliary examination is 94.73%,health guidance is 93.82%,all three have no statistical difference compared with Chongqing[2](P>0.05).The old people’s satisfaction with each EPHS was>90%,which was not statistically different from Chongqing[2](P>0.05).4.The elderly’s needs for other health services mainly include the following six aspects:personalized medical examination items,mental health consultation,popularization of first-aid knowledge,health medicine medication guidance,home care,oral health care.There are 248 elderly people(45.09%)in need of the above-mentioned services,among which 52.42%have the most elderly people who need personalized medical examination items.5.Logistic regression analysis results show:the influencing factors of ordinary elderly people’s lifestyle and health assessment are:type of household registration,living status,whether the service meets the needs,whether they know the service is free,whether it is convenient to obtain the service,and the overall satisfaction of the service;The influencing factors of medical examination are:whether you know that the service is free;the influencing factors of using the auxiliary examination are:age,whether you know the service is free,whether you trust the service;the influencing factors of using the health guidance are:age,whether you know the service is free.6.Logistic regression analysis results show:the factors affecting the assessment of lifestyle and health status of elderly people with hypertension/diabetes are:type of household registration,living status,frequency of participating in community activities,whether they drink alcohol,whether the service is useful,whether they know that the service is free;The influencing factors of using physical examination are:frequency of participation in community activities,overall health status,whether the service meets the needs,and whether the service is known to be free;the influencing factors of using auxiliary examinations are:frequency of participating in community activities,overall health status,whether the service is considered Useful,whether you know the service is free;the influencing factors of using health guidance are:the frequency of participating in community activities,whether the service is useful,whether you know the service is free,and whether the service meets the needs.Conclusion:1.The overall utilization level of the elderly EPHS in Chenggong District is better,but the utilization of lifestyle and health assessment services needs to be improved.Suggestion:People can post a family doctor contract service in the unit building of each community to promote it to the household;can also use various occasions such as market gatherings,parks,squares,etc.to explain the health knowledge and EPHS to the elderly to increase EPHS awareness and make more of the elderly use EPHS.2.Except for the assessment of lifestyle and health status,the utilization rate of EPHS among ordinary elderly people is higher than that of elderly people with hypertension/diabetes.Suggestions:For the elderly with high blood pressure and diabetes,set up a publicity and service system to improve their EPHS utilization level.3.The elderly have a low awareness rate of lifestyle and health assessment,and a high degree of satisfaction with each EPHS,all>90%.Suggestion:A lifestyle and health status assessment service group can be established to actively mobilize village doctors to concentrate the elderly,and use group propaganda to improve the awareness rate of lifestyle and health assessment.4.The elderly have a low demand for other health services.The existing EPHS can basically meet the needs of the elderly,but their needs for personalized medical examinations have not been met.Suggestion:Primary medical institutions can collect the medical examination needs of the elderly through village doctors and village cadres,and provide targeted personalized medical examination services to the elderly in need.5.Elders with non-chenggong hukou use EPHS higher than those with Chenggong hukou;older people living alone are more likely to use EPHS than non-single residents;older age,do not drink alcohol,sometimes participate in community activities,know the service Elders who are free of charge,think that the service meets their needs,have easy access to the service,trust the service,are satisfied with the service,and have good overall health use EPHS.Suggestions:Focus on Chenggong hukou and non-lonely elderly people;establish a cooperation mechanism with higher-level hospitals to improve the service capacity of primary medical institutions;actively coordinate multi-departmental cooperation with street offices,community neighborhood committees/village committees,etc.Adopting a variety of forms and channels to publicize on various occasions;increase the reimbursement ratio of medical insurance,increase the free information of publicity services,and solve the worries of the elderly. |
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