Isaranuwatchai Wanrudee, Guerriere Denise, Andrews Gavin J, Coyte Peter C
St Michael's Hospital, Centre for Excellence in Economic Analysis Research, Li Ka Shing Knowledge Institute, 193 Yonge Street, 8th Floor, Toronto, Ontario M5B 1M8, Canada.
Int Health. 2013 Jun;5(2):106-18. doi: 10.1093/inthealth/iht004.
On 26 December 2004, 280 000 people lost their lives in the Asia-Pacific region. A massive earthquake struck Indonesia, triggering a tsunami that affected several countries, including Thailand. This tsunami had important implications for the health status of Thai citizens and health planning, and thus there is a need to study its long-term impact.
This cohort study identified determinants of health service utilization (outpatient services, inpatient services, home care, medications and informal care) 1 and 2 years post-tsunami in Thailand. A two-part model with a multivariate logistic regression for each part was used to identify determinants of the propensity and intensity of utilization.
Of 1943 participants, 1889 (97.2%) participated at 1 year and 1814/1889 (96.0%) at 2 years. Common determinants of health service utilization in post-tsunami settings were age, marital status, education level, employment status, number of health conditions and (physical and mental) health status.
Knowing the determinants of health service use, health providers may be able to establish programmes for, or to carefully monitor populations, who are more likely to use services. The study results may be used to inform requests for health resources or to assist the development of guidelines for long-term disaster recovery planning.
2004年12月26日，亚太地区有28万人丧生。印度尼西亚发生强烈地震，引发海啸，影响了包括泰国在内的多个国家。此次海啸对泰国公民的健康状况和卫生规划产生了重大影响，因此有必要研究其长期影响。
这项队列研究确定了泰国海啸发生后1年和2年卫生服务利用（门诊服务、住院服务、家庭护理、药物治疗和非正式护理）的决定因素。使用一个两部分模型，每部分采用多元逻辑回归来确定利用倾向和利用强度的决定因素。
在1943名参与者中，1889人（97.2%）在1年时参与，1814/1889人（96.0%）在2年时参与。海啸后环境中卫生服务利用的常见决定因素包括年龄、婚姻状况、教育水平、就业状况、健康问题数量以及（身体和精神）健康状况。
了解卫生服务使用的决定因素后，卫生服务提供者或许能够为更有可能使用服务的人群制定相关计划或进行仔细监测。研究结果可用于为卫生资源申请提供参考，或协助制定长期灾难恢复规划指南。
