中国癌症患者医疗服务利用的城乡差异及相关因素
The Urban-Rural Disparities and Associated Factors of Health Care Utilization Among Cancer Patients in China.
作者信息
Wang Haipeng, Hua Xingxing, Yao Nengliang, Zhang Nan, Wang Jialin, Anderson Roger, Sun Xiaojie
机构信息
Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (Key Lab of Health Economics and Policy, National Health Commission), Shandong University, Jinan, China.
Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
出版信息
Front Public Health. 2022 Mar 4;10:842837. doi: 10.3389/fpubh.2022.842837. eCollection 2022.
OBJECTIVE
This study aimed to examine the urban-rural disparities and associated factors of health care utilization among cancer patients in China.
METHODS
This study used the data collected from a cross-sectional survey conducted in China. A total of 1,570 cancer survivors from three urban districts and five rural counties were selected by using a multistage stratified random sampling method. We measured health care utilization with the way of cancer diagnosis, the number of hospitals visited, and receiving alternative therapies. Chi-square test was used to examine the differences between urban and rural cancer patients. Binary logistic regression analysis was performed to explore the determinants of health care utilization.
RESULTS
Among 1,570 participants, 84.1% were diagnosed with cancer after developing symptoms, 55.6% had visited two and above hospitals, and 5.7% had received alternative therapies. Compared with urban cancer patients, rural ones were more likely to be diagnosed with cancer after developing symptoms (χ2 = 40.04, < 0.001), while they were less likely to visit more than one hospital (χ2 = 27.14, < 0.001). Residence area (urban/rural), health insurance type, household income, age at diagnosis, tumor site, stage of tumor, and survival years were significantly associated with health care utilization of cancer patients ( < 0.01).
CONCLUSIONS
Health care utilization was suboptimal among cancers patients in China. Rural cancer patients had less health care utilization including screenings and treatments than urban ones. Policymakers should implement specific strategies to ensure equitable utilization of cancer care. More attention should be paid to the disadvantaged groups and rural cancer patients. Prioritizing health resources allocation is needed to prevent, screen, and treat cancers in rural areas.
目的
本研究旨在探讨中国癌症患者医疗服务利用的城乡差异及相关因素。
方法
本研究使用了在中国进行的横断面调查收集的数据。采用多阶段分层随机抽样方法,从三个城市区和五个农村县选取了1570名癌症幸存者。我们通过癌症诊断方式、就诊医院数量和接受替代疗法来衡量医疗服务利用情况。采用卡方检验来检验城乡癌症患者之间的差异。进行二元逻辑回归分析以探讨医疗服务利用的决定因素。
结果
在1570名参与者中,84.1%在出现症状后被诊断出患有癌症,55.6%就诊过两家及以上医院,5.7%接受过替代疗法。与城市癌症患者相比,农村癌症患者在出现症状后更有可能被诊断出癌症(χ2 = 40.04,P < 0.001),而他们就诊多家医院的可能性较小(χ2 = 27.14,P < 0.001)。居住地区(城市/农村)、健康保险类型、家庭收入、诊断时年龄、肿瘤部位、肿瘤分期和生存年限与癌症患者的医疗服务利用显著相关(P < 0.01)。
结论
中国癌症患者的医疗服务利用情况欠佳。农村癌症患者的医疗服务利用,包括筛查和治疗,比城市患者少。政策制定者应实施具体策略,以确保癌症护理的公平利用。应更加关注弱势群体和农村癌症患者。需要优先分配卫生资源,以预防、筛查和治疗农村地区的癌症。