Wan Y, Wang N L, Hao J, Dong Z, Zhang Y, Cao K
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Yan Ke Za Zhi. 2018 Aug 11;54(8):570-579. doi: 10.3760/cma.j.issn.0412-4081.2018.08.003.
To assess the utilization of eye care services in the rural area of Handan, China under the New Rural Cooperative Medical Scheme, and to analyze the factors associated with the uptake of these services. In a cohort population-based study, subjects who joined both the baseline (2006-2007) and follow-up (2012-2013) were included. Information of demographic characteristics, participation in the New Rural Cooperative Medical Insurance and use of eye care services, comprehensive ophthalmic examinations, blood pressure and fasting was collected. The protocol got approved by the ethics committee of Beijing Tongren Hospital, and each subject signed the informed consent. Of 5 193 eligible participants, 549 [10.6%; 95% confidence interval (), 9.8%-11.4%] had used eye care services, and the prevalence had no significant difference from baseline surveys (0.20). The municipal hospitals undertook 50.1% of eye care services. "No need" (4 422, 95.2%) was the most common reason cited for not using an eye care service; 2 875 (65.0%) of these participants had at least one type of eye diseases, 3 505 (79.3%) had at least one type of ocular complaints. In the multiple binary logistics regression model, participants who were elder [adjusted odds ratio (), 1.319; 95, 1.177-1.478], were female (adjusted , 1.466; 95, 1.085-1.981), had a diabetes history (adjusted , 1.930; 95, 1.381-2.696), had a low income (adjusted , 0.826; 95, 0.688-0.922), had ocular complaints (adjusted , 3.556; 95, 2.484-5.091), had refractive errors (adjusted , 1.256; 95, 1.007-1.567), had visual impairment (adjusted , 4.398; 95, 2.667-7.253) or had cataract (adjusted , 1.278; 95, 1.013-1.612) were more likely to take an eye care service. Under the New Rural Cooperative Medical Scheme, the prevalence of New Rural Cooperative Medical Insurance was increased significantly, but the rate of eye care use in the rural area was still low. Further efforts towards higher quality medical service in county hospitals and village clinics as well as better education about eye disease among the rural population may raise the eye care use in rural areas. .
为评估中国邯郸市农村地区在新型农村合作医疗计划下眼保健服务的利用情况,并分析与这些服务利用相关的因素。在一项基于队列人群的研究中,纳入了参加基线调查(2006 - 2007年)和随访(2012 - 2013年)的受试者。收集了人口统计学特征、新型农村合作医疗保险参与情况、眼保健服务使用情况、综合眼科检查、血压和空腹情况等信息。该方案获得了北京同仁医院伦理委员会的批准,每位受试者签署了知情同意书。在5193名符合条件的参与者中,549人[10.6%;95%置信区间(),9.8% - 11.4%]使用了眼保健服务,患病率与基线调查(0.20)无显著差异。市级医院承担了50.1%的眼保健服务。“不需要”(4422人,95.2%)是未使用眼保健服务最常提及的原因;这些参与者中有2875人(65.0%)至少有一种眼病,3505人(79.3%)至少有一种眼部不适。在多元二元逻辑回归模型中,年龄较大的参与者[调整后的优势比(),1.319;95%,1.177 - 1.478]、女性(调整后,1.466;95%,1.085 - 1.981)、有糖尿病史(调整后,1.930;95%,1.381 - 2.696)、低收入(调整后,0.826;95%,0.688 - 0.922)、有眼部不适(调整后,3.556;95%,2.484 - 5.091)、有屈光不正(调整后,1.256;95%,1.007 - 1.567)、有视力损害(调整后,4.398;95%,2.667 - 7.253)或有白内障(调整后,1.278;95%,1.013 - 1.612)更有可能接受眼保健服务。在新型农村合作医疗计划下,新型农村合作医疗保险的普及率显著提高,但农村地区眼保健服务的使用率仍然较低。进一步努力提高县级医院和乡村诊所的医疗服务质量,以及加强农村人群的眼病教育,可能会提高农村地区眼保健服务的使用率。