Niu Hongli, Tian Miaomiao, Ma Anning, Wang Chunping, Zhang Liang
School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Center for Policy and Health Management, Chinese Academy of Medical Sciences, Beijing 100020, China.
Chin Med J (Engl). 2014;127(9):1626-32.
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.
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.
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.
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.
自2009年起，中国启动了医疗卫生体制改革，为全体居民提供基本公共卫生服务，以确保服务公平性和可及性，实现全体人群健康水平的持续提升。本研究旨在调查中国不同特征人群在获得基本公共卫生服务方面的差异及影响因素，尤其是高血压患者和0至6岁儿童。
采用横断面研究并进行社会人口学数据分析，以评估高血压患者和儿童接受基本公共卫生服务的分布特征。定期随访和有效的血压控制反映了对高血压患者的有效管理，对于儿童而言，提供的公共服务包括按时接种疫苗和定期体格检查。采用逻辑回归分析确定有效管理的预测因素。
共纳入1505例高血压患者和749名儿童；39.14%的高血压参与者能够将血压控制在正常范围内，城区的控制率（43.61%）高于农村（31.88%）。其中34.68%的患者能够接受医护人员4次以上的随访。在754名儿童中，79.84%能够接受定期体格检查，98.40%按时接种了疫苗。农村地区的儿童更有可能接受定期体检（83.96%）和定期接种疫苗（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。
2009年以来的医疗卫生体制改革使中国公共卫生体系朝着正确方向发展，推动了公共卫生体系建设的进步。我们的研究凸显了中国对更多公共卫生服务日益增长的需求，中国公共卫生体系在质量和可及性方面仍需大幅改进。
