Differences and determinants in access to essential public health services in China: a case study with hypertension people and under-sixes as target population
Differences and determinants in access to essential public health services in China: a case study with hypertension people and under-sixes as target population
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中国基本公共卫生服务获取差异及影响因素：以高血压人群和6岁以下儿童为目标人群的案例研究
DOI：
10.3760/cma.j.issn.0366-6999.20132786
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发表时间：
2014-05-05
影响因子：
6.1
通讯作者：
Zhang Liang
中科院分区：
文献类型：
--
作者：
Niu Hongli;Tian Miaomiao;Zhang Liang
自2009年以来的背景，在中国进行了卫生改革，并为所有居民提供了基本的公共卫生服务，以确保服务公平和可及性，并实现持续的人口范围的健康改善。这项研究旨在调查中国具有不同特征访问基本公共卫生服务的不同特征的人群之间的差异和决定因素，尤其是0-6岁的高血压人员和儿童。方法进行了一项具有社会人口统计学数据分析的横断面研究，以估算接受高血压患者和儿童的基本公共卫生服务的分配特征。定期随访和有效的血压控制反映了高血压患者的有效管理，而儿童的公共服务是按计划和定期进行身体检查的疫苗接种。逻辑回归用于确定有效管理的预测因子。总共涉及1505例高血压患者和749名儿童。 39.14％的高血压参与者可以控制正常范围内的血压，而城市地区（43.61％）的速度高于农村地区（31.88％）。他们中有34.68％的医疗技术人员可以接受4次以上的随访。在754名儿童中，有79.84％的儿童可以定期进行体格检查，而98.40％的儿童定期接种疫苗。居住在农村地区的儿童更有可能进行定期检查（83.96％）和常规疫苗接种（接近99％）。总体而言，地理位置和教育水平是人们获得基本公共卫生服务的决定因素。自2009年以来，牢固的卫生改革实施将中国的公共卫生系统朝着正确的方向领导，并促进了公共卫生系统开发的改善。我们的研究强调了在中国对更多公共卫生服务的日益增长的需求，并且中国的公共卫生系统必须在其质量和可及性方面得到极大的改善。
Background Since 2009, health reform had launched in China and essential public health services were provided for all residents to ensure service equity and accessibility, and to achieve sustained population-wide health improvement. This study aimed to investigate the differences and determinants among populations with different characteristics access to essential public health services in China, especially hypertension people and children aged 0-6 years.Methods A cross-sectional study with socio-demographic data analysis was undertaken to estimate distribution characteristics of receiving essential public health services of hypertension patients and children. Regular follow-ups and effective blood pressure control reflected the effective management for hypertension patients, and for children, public services provided were vaccination on schedule and regular physical check-up. Logistic regression was used to determine the predictors for effective management.Results A total of 1 505 hypertension patients and 749 children were involved; 39.14% of hypertension participants could control their blood pressure in the normal range, and the rate in urban areas (43.61%) was higher than that in rural (31.88%). And 34.68% of them could receive more than 4 times follow-ups by the medical technician. Of 754 children, 79.84% could receive the periodic physical examination and 98.40% had vaccinated regularly. Children living in rural areas were more likely to have regular check-ups (83.96%) and regular vaccination (nearly 99%). Overall, geographic location and education level were the determinants of people access to essential public health services.Conclusions Implementation of the health reform since 2009 has headed China's public health system in the right direction and promoted the improvement of public health system development. Our study highlights the growing needs for more public health services in China, and China's public health system needs to be greatly improved in terms of its quality and accessibility.