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Objective To understand the current situation and explore the influencing factors of delay in seeking medical treatment for common symptoms of residents in the rural areas of Sichuan province. Methods In July 2019,multi-stage random sampling was carried out in Zigong city,Sichuan province,and the data were collected by face-to-face questionnaire interview.The residents who had lived at hometown for more than half a year in the past year and had seen a doctor in the most recent month were surveyed.Logistic regression was adopted to predict the influencing factors of delay in seeking medical treatment. Results A total of 342 subjects were enrolled,and the incidence of delay in seeking medical treatment was 13.45%(46/342).Compared with the young and middle-aged(<65 years)people,the elderly(≥65 years)people were more likely to have delay in seeking medical treatment (OR=2.187,95%CI=1.074-4.457,P=0.031).The rural residents who gave higher score of the overall quality of township health centers were less likely to have delay in seeking medical treatment (OR=0.854,95%CI=0.735-0.992,P=0.039). Conclusions The occurrence of delay in seeking medical treatment for common symptoms of rural residents in Sichuan province is low.Age and the overall quality evaluation of township health centers affect the occurrence of delay in medical treatment among the rural residents in Sichuan province.Efforts should be made to improve the awareness of disease prevention among the elderly in rural areas.The investment in health resources in township health centers should be increased to strengthen the introduction and training of talents.These measures can improve the health services in township health centers,guide residents to make timely use of health resources,and reduce the occurrence of delay in seeking medical treatment.
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Middle Aged , Aged , Humans , Surveys and Questionnaires , Logistic Models , Rural Population , China/epidemiologyABSTRACT
This standard stipulates the principles, institutional requirements, inspection items, service modes, data management and utilization requirements for carrying out the health check-up for rural residents. It is applicable to the standardized management of the health check-up for rural residents aged 15 years old and above under the relevant national laws and regulations.
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With the acceleration of the population aging in China, the health problems and the demands of health services such as health check-up for rural residents should attract the attention of the whole society. The group standard entitled Health check-up guide for rural residents (T/CHAA 005-2019), was written by experienced researchers from Chinese Center for Disease Control and Prevention and other professional institutes coordinated by Chinese Health Association. The standard aims to establish a service model that takes health information collection as a means, health risk assessment, health risk intervention and information services as the core, improving the health of rural residents as the target.
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Objective:To investigate the health - related quality of life of rural residents in Shandong Province and analyze its influencing factors. Methods:EQ - 5D scale was used to measure the health - related quality of life of rural residents in Shandong Province,and Chi - square test,t test and multiple linear regression were used to ana-lyze its influencing factors. Results:The main health problems of rural residents in Shandong Province were pain /discomfort,and the score of EQ - VAS of surveyed population was(82. 78 ± 15. 68). The health - related quality of life of rural women was poor; the abilities of action,self - care,and daily activities of residents above 60 years old declined sharply,and subjects with no spouse and low level education faced more health problems. Age and chronic disease were the major factors that influenced quality of life. Conclusion:Grasping the life quality characteristics of different age groups and strengthening the prevention and control of chronic diseases in rural areas are of great sig-nificance for effectively improving the health - related quality of life of rural residents in Shandong Province.
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Objective:To calculate the government and society financing limit under different compensation schemes in Inner Mongolia Autonomous Region,forecast the funding level for the next 5 years;to analyze the financing ability of government and society under different compensation schemes in the process of integration of basic medical insurance for urban and rural residents in Inner Mongolia Autonomous Region.Methods:Based on the Even Difference Grey model,it simulated and forecasted the government and social future financing levels for the next 5 years.Based on the Synthetic Degree of Incidence model,it analyzed the feasibility of government and society under different compensation schemes.Results:No matter under which type of compensation schemes,the funding body of government and society occupied a dominant position,and the amount of financing has increased rapidly.From 2011 to 2015,the growth rate was above doubled.In the next 5 years,the growth rate has reached to tripled.According to the calculation of 3 types of compensation schemes(30％ of outpatients and 60％ of hospitalized patients,30％ of outpatients and 70％ of hospitalized patients,40％of outpatients and 70％ of hospitalized),the government and society financing was more feasible under these three types of compensation schemes.Conclusion:The amount of government and social financing raising continues to increase,it faced enormous challenges.In terms of feasibility,there were 3 types of compensation programs which were more reasonable.
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Objective:To calculate the medical compensation fee,management fee and risk reserve in the medical insurance fund of Inner Mongolia,calculate the total financing amount of the medical insurance fund under the different compensation scheme in 2011-2015 and the amount of fund-raising fund of the per capita health insurance fund,and study the financing feasibility of urban and rural areas in Inner Mongolia in the integration process of Basic Medical Insurance for urban and rural residents.Methods:The medical insurance fund under different compensation schemes in Inner Mongolia was calculated by using the residual qualified model,the correlation degree qualified model,the variance ratio qualified model and the small error probability qualified model.Results:The average health insurance fund under the five compensation schemes in 2011-2015 was between 521.43 yuan and 2012.27 yuan.The five compensation schemes were to be raised between 128.85 yuan and 49.73 billion yuan respectively.Based on different kinds of compensation program,the financing amount of basic medical insurance fund for urban and rural residents in Inner Mongolia increased by years.The average annual growth rate was 20％,the average annual growth rate of per capita health insurance fund financing was 10％.Conclusion:The amount of fund raising increased quickly by years with high financing pressure.This was a difficult task for the advancement of the integration of basic medical insurance for urban and rural residents in Inner Mongolia.Meanwhile,it provided a scientific and effective financing plan of insurance fund for promoting the integration of basic medical insurance in Inner Mongolia.
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Objective:To estimate the medical compensation fees in medical insurance fund under different compensation schemes in Inner Mongolia,and to study the feasibility of financing in the integration process of basic medical insurance for urban and rural residents in Inner Mongolia Autonomous Region.Methods:Based on the method of ratio method,original difference GM (1,1) model,Delphi method and moving average,the medical compensation fees under different compensation schemes in Inner Mongolia in 2015 was calculated.Results:Ignoring the factors such as pay line and cap line,the total compensation for medical expenses under the five medical compensation schemes were 18.778 billion yuan,25.355 billion yuan,30.351 billion yuan,32.346 billion yuan and 46.04 billion yuan.Conclusion:Based on the measurement of medical compensation under different compensation schemes,it calculated the financing amount of the integration of medical insurance,analyzed the feasibility of the basic medical insurance financing in Inner Mongolia.In the treatment of growth factors,insurance factors and other indicators,the innovative use of a variety of methods combined approach,scientific and effective calculation of the growth factor and insurance factor,revised a part of the annual growth factor which had large growth,the insurance factor value was too high and other problem,in order to accurately assess the medical compensation.
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Objective To study the current situation and predilection of the annual outpatient services as used by rural residents in China ,and the characteristics and regional differences .Methods A stratified random sampling survey was adopted to extract 12 villages out of 6 counties across China , and the outpatients′personal clinical records were merged from all levels of local medical institutions . Descriptive statistics andχ2 test were employed to analyze their utilization .Results The survey showed that Huangzhong ,Xixian and Huzhou counties had lower access to health resources per thousand peoples than the other 3 counties ,as the outpatient visits were also lower than the latter .50％ of the outpatient services of the six counties in 2014 (217881/403707)were used by 20％ of the rural residents(23326/109058) .In most counties ,service utilization of primary institutions accounted for over 65％ (299228/371623)of the county .Conclusions The utilization of outpatient service in these counties presents aggregation effect to some extent.Irrational utilization was found in some areas and hierarchical medical system needs to be improved .
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Objective To study the influencing factors of the medical behaviors between urban and rural residents in Hubei province .Methods The survey selected 454 families in Wuhan and Macheng ;investigated their family income ,health condition and medical behaviors ,multiple correspondence and logistic regression were applied to study the influence factors of medical behaviors . Results 845 people(85.05％ )selected primary medical institutions ,and 126 people(12.83％ )selected secondary medical institution in Macheng ;321 people(47.53％ )selected primary medical institutions , and 283 people (42.30％ )selected tertiary medical institutions in Wuhan ;Macheng and Wuhan′s Cronbach′s alpha reliability coefficients for multiple correspondence model are 0.57 and 0.72 respectively ,and nagelkerke R2 for logistic regression model are 0.56 and 0.59 respectively ;Both urban and rural residents selected medical institutions depending on types of diseases ;family income influences the selection of medical institution of Macheng residents ;age and economic contribution have a great effect on medical behaviors of Wuhan resident .Conclusions Family economic income constitutes a major factor for senior people ,while such factor poses different influences over different medical insurance and economic level of these people .
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Objective:To figure out the characteristics of annual medical expenditure for rural residents and its distribution among different population.Methods:The individual annual medical service utilization information was summarized after dealing with the database of the 2014 new rural cooperative medical system by Excel.It prescribed the clustering of medical expenditure by Lorenz curve and Gini index.Descriptive statistics and x2 test were used to compare the characteristics and distribution of the annual medical expenditure among rural residents.The Chi-square test was conducted to compare the differences of the population distribution.Results:The costliest 5％ patients accounted for approximately 68％ of total health care expenditure.The annual total expenditure was 16628 yuan per capita among high-cost population,while low-cost population were 108 yuan.The Gini index of medical expenditure for rural residents was 0.81.Among female and population over 45 years old,the proportion of high-cost population was higher than 5％.People living near provincial road,in flatlands or areas where the ability of township hospital was limited were nore likely to expense higher medical costs,known as 6.40％,5.50％ and 5.80％ separately.Conclusion:Clustering of medical expenditure for rural residents was remarkable,while the expenditure among high-cost,medium-cost and low-cost population were quite different.The elderly,female and primary population living in areas where the ability of township hospitals were limited were more likely to generate high medical costs.
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Objective:Under the premise of the policy of everybody has medical insurance,it discussed the integration plan of the basic medical insurance system for urban and rural residents in Tibet about the problems and the countermeasures.Methods:Descriptive and contrastive methods were used to analyze the status of urban and rural medical system operation in Tibet.Results:The problem of unbalanced development of urban and rural medical and health services in Tibet and the management of post-merger were put forward.Conclusion:It was necessary to put forward policy recommendations from the aspects of horizontal co-ordination,multi-sectoral collaborative management,unified medical insurance information management system,hierarchical diagnosis and treatment mechanism,perfect Tibetan medicine reimbursement catalog,one system and multiple files and vertical co-ordination,and gradually realize the urban and rural medical insurance in Tibet System integration.
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The paper introduces the application practice and characteristics of foreign health kiosks and the Taobao modes in the rural areas of China,and puts forward the assumption of using health kiosks in the rural areas of China.The health kiosks should be set up in the village clinics to provide the health information required for rural residents under the guidance of village doctors.
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Objective:To investigate the policy changes of medical insurance for urban and rural residents in Urumqi before and after the integration,so as to provide suggestion for the development of urban and rural medical insurance whole as plan.Methods:The health care financing after integration standards,reimbursement ratio and the changes of management methods were analyzed.Results:The personal financing standard and the starting line for patients who participated New Rural Cooperative Medical Insurance in tertiary hospitals raised after medical insurance,which effected the medical choice of patients participated the medical insurance to a certain extent.The gap between urban and rural areas affected the integration of urban and rural residents health care work.Conclusion:The level of individual pay cost should be consistent with the level of treatment in the design of ginseng protect personnel It needed to increase the government support,payment standard and treatment standard reference or innovation.
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Objective To study the rural residents′ satisfaction for services of village clinics in Shandong province, identify the influencing factors and put forward feasible suggestions and countermeasures. Methods The method of multi-stage stratified random sampling was used in 54 villages of 18 counties from six prefectures,with 1 590 rural residents randomly sampled for questionnaire survey and interview. This survey called into play the composition ratio for descriptive analysis,and univariate analysis and multinomial logistic regression for identifying the influencing factors. Results The rural residents′overall satisfaction for services of village clinics was acceptable as 65.6% of them were satisfied,yet still at a low level. Major influencing factors for the satisfaction are service attitude and communication ability of rural doctors, drug availability at village clinics, and conditions of equipments and environment. Conclusions Authors proposed such measures as strengthening training of the service attitude and communication ability of rural doctors, scientifically adjusting and refining the types and quantities of essential drugs and continuing to better the conditions of equipments and environment of village clinics. These measures aim at further improving rural residents′satisfaction for services of village clinics.
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Objective To understand the prevalence of hypertension and quantitative relationship between family history and the risk of hypertension among rural residents living in Hanzhong District,Shaanxi province.Methods A multistage random sampling survey was conducted.Data on the characteristics related to hypertension were collected and physical examination was conducted.Logistic regression was used to analyze the relationship between family history and hypertension.Results A total number of 2 817 rural residents aged 18-80 with complete information were recruited.The crude prevalence of hypertension was 33.7％.Results from the logistic regression analysis showed that the OR was 2.06 (95％ CI:1.70-2.50) between family histories with or without hypertension.When the first-degree relatives were with the degrees of family history of hypertention as Ⅰ,Ⅱ or llⅢ,the OR values of hypertension appeared as 1.83 (95％C1:1.47-2.27),2.94 (95％CI:2.09-4.13) and 4.48 (95％ CI:2.17-9.27) respectively.Either father or mother having the positive family history of hypertension,the corresponding OR values appeared as 2.50 (95％ CI:1.84-3.40),1.61(95％CI:1.22-2.12) seen in mothers.However,when both father and mother having the family history of hypertention,the OR value was seen 2.82 (95％CI:1.76-4.51) in the mothers.Conclusion Family history appeared as a risk factor for hypertension.The number of first-degree relatives with positive family history showed a dose-response relationship to the occurrence of hypertension.Family history in both father or mother might further affect the incidence of hypertension.
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Objective To understand the prevalence of hypertension and quantitative relationship between family history and the risk of hypertension among rural residents living in Hanzhong District,Shaanxi province.Methods A multistage random sampling survey was conducted.Data on the characteristics related to hypertension were collected and physical examination was conducted.Logistic regression was used to analyze the relationship between family history and hypertension.Results A total number of 2 817 rural residents aged 18-80 with complete information were recruited.The crude prevalence of hypertension was 33.7％.Results from the logistic regression analysis showed that the OR was 2.06 (95％ CI:1.70-2.50) between family histories with or without hypertension.When the first-degree relatives were with the degrees of family history of hypertention as Ⅰ,Ⅱ or llⅢ,the OR values of hypertension appeared as 1.83 (95％C1:1.47-2.27),2.94 (95％CI:2.09-4.13) and 4.48 (95％ CI:2.17-9.27) respectively.Either father or mother having the positive family history of hypertension,the corresponding OR values appeared as 2.50 (95％ CI:1.84-3.40),1.61(95％CI:1.22-2.12) seen in mothers.However,when both father and mother having the family history of hypertention,the OR value was seen 2.82 (95％CI:1.76-4.51) in the mothers.Conclusion Family history appeared as a risk factor for hypertension.The number of first-degree relatives with positive family history showed a dose-response relationship to the occurrence of hypertension.Family history in both father or mother might further affect the incidence of hypertension.
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Objective To know the prevalence of anorectal disease and its influencing factors among rural residents in Lanxi city.Methods A cluster sampling method was performed,a total of 2 287 residents aged 1 8 years and over were selected. A questionnaire interview and physical examination were carried out.Results The prevalence of anorectal diseases was 64.1 5% totally,with female 73.02% and male 52.66%,respectively.Multivariate analysis showed that gender,age, marriage status,working intensity,defecation habit,family history of anorectal disease and body mass index were the influencing factors (P <0.01 ).Conclusion The prevalence of anorectal diseases was relatively high among rural residents in Lanxi city.The colonoscopy should be recommended and health education should be taken in general physical examination.
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Objective To understand the prevalence of diabetes and its influencing factors among rural residents in Fengdu coun-ty of Chongqing and to provide the suggestion for diabetes prevention and control.Methods Rural residents aged above 18 years old were sampled by stratified clustered random sampling.The data was entered by software Epi data3.02 and analyzed by SPSS 16.0.The rate was compared by Chi-square test.The influencing factors of diabetes was identified by multivariate logistic regres-sion.Results A total of 623 rural residents was investigated.The average age was (51.3±1.4)years old.The rate of smoking at present was 20.2% and the rate of smoking at present among male rural residents was 53.0%.The rate of passive smoking was 38.2%.The rate of drinking alcohol in the past 12 months was 22.8%.And its rate of male residents was 41.7%.The awareness rate of height,body weight,waist circumference,blood pressure and blood glucose was 9.5%,13.6%,1.9%,50.1% and 12.4%respectively.The crude and adjusted prevalence of obesity,hypertension and diabetes was 11.4% and 8.3%,52.5% and 28.4%, 12.0% and 9.3%.The result of multivariate logistic regression indicated that whether parents had diabetes(OR=0.20,95%CI :0. 04-0.94)and whether participants was diagnosed to be hypertension (OR=2.31,95%CI :1.19-4.49)was the independent fac-tor of diabetes.Conclusion The prevalence of diabetes among rural residents in Fengdu county of Chongqing was high.The risk factors such as smoking,alcohol use and unbalance diet was common.It should be strengthened to conduct the comprehensive ine-trevention for diabetes in rural area.
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Objective To explore the difference of social support,self-esteem and marital quality between urban and rural areas and discuss the impact on each other.Methods Chinese marital quality questionnaire,selfesteem scale (SES) and social support rating scale were used to test 386 urban and rural married residents.Results ①The results of descriptive statistics showed that marriage quality,social support and self-esteem of urban and rural residents were (318.46±37.41),(42.44±5.84) and (30.65 ± 3.95) respectively.②There was no significant difference among social support,self-esteem and marital quality in different gender(t =0.41,-0.16,0.03,P＞ 0.05),but had significant difference between urban and rural areas(t=2.83,3.91,5.24,P＜0.01).There were significant differences between social support and marital quality in different age structures(t=5.22,3.85,P＜0.05).There were significant differences between social support and self-esteem in different educational level (t =3.48,4.16,P＜0.01).③Social support,subjective support,objective support and marital quality had positive correlation (r=0.114～0.394,P＜0.05).The degree and character compatibility,communication between couples,resolve conflicts are positively related to support (r=0.308～ 0.476,P＜0.01).④Stepwise multiple regression analysis and structural equation modeling analysis showed that self-esteem played partial intermediary role between social support and marital quality(37.7％),which could explain 26.8％ of marital quality.The social suptort and self-esteem could better predict marital quality.Conclusion The higher social support and self-esteem are,the higher marital quality is.Social support can directly affect the marital quality and indirectly affect marital quality through self-esteem.
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Objective To understand the prevalence of hypertension and diabetes and its associated factors among rural resi-dents in Chongqing ,in order to provide the evidence for conducting non-communicable disease prevention and control in rural area . Methods Rural residents aged above 18 years old were sampled by multi-stage stratified random sampling .The resident sampled was interviewed with the structured questionnaire by face-to-face and examined body weight ,height ,blood pressure ,waist circum-ference .The blood sample was taken to test fasting glucose ,2 h glucose .The associated factors of hypertension and diabetes were i-dentified by Chi-square test and the independent factors of hypertension and diabetes were identified by Logistic regression .Results A total of 2 406 rural residents were interviewed .The amount of salt in taking and oil in taking per person per day self-reported was 6 .7 g and 44 .4 g .The proportion of smoking among rural residents was 21 .0% .The proportion of alcohol use in the past 12 months was 22 .4% .32 .6% of interviewees participated in the regular physical activity .The proportion of overweight and obesity a-mong rural residents was 25 .4% and 6 .2% .The prevalence of hypertension and diabetes was 22 .0% and 9 .4% .The independent factor of hypertension was age(OR = 1 .83 ,95% CI :1 .68 - 1 .98) ,education level(OR = 0 .67 ,95% CI :0 .55 - 0 .82) ,body index(OR= 1 .68 ,95% CI :1 .44 - 1 .96) ,blood glucose(OR = 0 .60 ,95% CI :0 .51 - 0 .70) .The independent factor of diabetes was age(OR =1 .33 ,95% CI :1 .20 - 1 .48) ,gender(OR = 1 .48 ,95% CI :1 .11 - 1 .98) ,education level(OR = 0 .77 ,95% CI :0 .60 - 0 .98) ,body in-dex(OR = 1 .40 ,95% CI :1 .16 - 1 .70) and blood pressure(OR = 0 .77 ,95% CI :0 .64 - 0 .93) .Conclusion The prevalence of hyper-tension and diabetes was high .The risk factors such as unhealthy diet ,physical inactivity ,smoking ,harmful alcohol use ,overweight and obesity is common among rural residents .It should be attached an importance on non-communicable disease prevention and con-trol in rural area .