首页|重庆市尘肺病患者门诊服务利用情况及影响因素分析

重庆市尘肺病患者门诊服务利用情况及影响因素分析

Utilization of outpatient service of pneumoconiosis patients in Chongqing and its influencing factors

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目的 了解重庆市尘肺病患者两周内门诊服务利用情况及特点,并分析其影响因素,为相关政策制定提供参考依据.方法 于2020年10月至2022年10月,采用多阶段分层随机整群抽样,选取1 771名符合纳入标准的尘肺病患者为研究对象,对其基本情况、两周内门诊服务利用情况、因尘肺病相关症状治疗情况、医疗服务机构选择情况等进行问卷调查,用x2检验和logistic回归进行数据统计分析.结果 1771例尘肺病患者均为男性,平均年龄(56.1±10.19)岁,两周内门诊就诊尘肺病患者中,年龄41~50岁患者占40.0%(204/510);农村患者占87.8%(448/510);矽肺患者占65.1%(332/510),贰期患者占37.5%(191/510),诊断尘肺后未继续从事接尘工作患者占75.1%(383/510),工作时从来没有工伤保险患者占57.1%(291/510).获得尘肺相关救助和有低保患者两周内门诊率分别为17.6%(90/510)和12.5%(64/510),患者自我健康评分为3分(41~60/中等)者占59.1%(301/510),有并发症、有尘肺病相关症状加重和一年内有住院史的患者分别占97.8%(499/510)、78.8%(402/510)和76.5%(390/510).患者自我健康评分平均得分(52.9±16.2)分;28.2%的患者购买过工伤保险;两周内进行治疗患者1 204例,门诊就诊者42.2%,住院治疗者20.7%,自己买药者36.9%,患者不同治疗方式间差异有统计学意义(x2=27.53,P<0.01);不同居住地患者选择到不同医疗机构就诊的差异有统计学意义(x2=13.97,P<0.05);患者尘肺病期别、有无并发症、有无工伤保险、自我健康评分、近一年是否住过院等是影响尘肺病患者门诊就诊的重要因素.结论 尘肺病患者门诊利用情况受人口社会学、社会支持、疾病特征多因素的影响,应加强基层卫生机构的职业病医疗服务质量,让尘肺病患者能获得便利有效的治疗;建立更完善的社会保障支持体系,减轻尘肺病患者疾病负担.
Objective To understand the utilization and characteristics of outpatient services for pneumoconiosis patients within two weeks in Chongqing,and analyze the influencing factors,so as to provide reference for relevant policy making.Methods From October 2020 to October 2022,1771 pneumoconiosis patients who met the inclusion criteria were selected by multi-stage stratified random cluster sampling.A questionnaire survey was conducted on their basic situation,utilization of outpatient services within two weeks,treatment for pneumoconiosis-related symptoms,and selection of medical service institutions using x2-test and logistic regression analysis.Results All the 1771 pneumoconiosis patients were male,with the average age of(56.1±10.19)years old.In the pneumoconiosis patients were treated in outpatient department within 2 weeks.40.0%(204/510)of aged 41~50 years Rural patients accounted for 87.8%(448/510);65.1%(332/510)of silicosis patients,37.5%(191/510)of stage Ⅱ patients,75.1%(383/510)of patients did not continue to engage in dust work after diagnosis of pneumoconiosis,and 57.1%(291/510)of patients never had work-related injury insurance at work.The outpatient rate within two weeks of pneumoconiosis related assistance and subsistence allowance was 17.6%(90/510)and 12.5%(64/510),respectively.The average self-health score of the patients was(52.9±16.2).28.2%of the patients had purchased work-related injury insurance;Among the 1204 patients who received the treatment within two weeks,42.2%were in the outpatient department,20.7%were in the inpatient department,and 36.9%were self-buyers.There was a significant difference between the different treatment methods of the patients(x2=27.53,P<0.05).There was a significant difference in patients from different residence choosing to visit different medical institutions(x2=13.97,P<0.05).The stage of pneumoconiosis,presence of complications,presence of work injury insurance,self-health score,and whether he/she has been hospitalized in the past year are the important factors affecting the outpatient treatment of pneumoconiosis patients.Conclusion The utilization of outpatient service of pneumoconiosis patients is influenced by demographic sociology,social support and disease characteristics.The quality of occupational disease medical service in primary health institutions should be strengthened so that pneumoconiosis patients can get convenient and effective treatment.Establish a more perfect social security support system to reduce the disease burden of pneumoconiosis patients.

PneumoconiosisMedical seeking behaviorOutpatient rate

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重庆医科大学公共卫生学院,重庆 401331

重庆市职业病防治院职业卫生与中毒应急办公室,重庆 400060

尘肺病 就医行为 门诊率

重庆市科卫联合医学科研项目

2022MSM129

2024

中华劳动卫生职业病杂志
中华医学会

中华劳动卫生职业病杂志

CSTPCD北大核心
影响因子:0.787
ISSN:1001-9391
年,卷(期):2024.42(6)