Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, 530021, Nanning, Guangxi, China.
School of Public Health and Health Management, Gannan Medical University, 341000, Ganzhou, Jiangxi, China.
BMC Public Health. 2024 Mar 28;24(1):919. doi: 10.1186/s12889-024-18435-8.
The burden of chronic diseases has become a major public health concern, and high-efficiency use of community health services is essential in combating chronic diseases. This study described the status of chronic diseases in southern China and explored the determinants of health service utilization among adult residents.
Data were obtained from one part of community survey data from four counties in Ganzhou City, southern China. A multistage, stratified random sampling method was used to conduct a cross-sectional survey between 2018 and 2020. Overall, 7430 valid questionnaires were collected. A lasso-linear regression analysis was performed to explore the determinants of community health service utilization.
According to the study, most participants (44.6%) reported having relatively good health, while 42.1% reported having moderate health. Chronic diseases were reported by 66.9% of the respondents. The three most prevalent self-reported chronic diseases were hypertension (22.6%), hyperlipidemia (5.9%), and diabetes (5.9%). Among residents with chronic diseases, 72.1% had one chronic disease, while the rest had multiple. Only 13.9% of residents frequently utilized community health services, while 18.9% never used them. Additionally, among residents who reported having chronic diseases, 14.1% had never attended community health services. Four categories of factors were the key determinants of community health service utilization: (1) personal characteristics, age, and sex; (2) health-related factors, such as family history, self-reported health conditions, and the number of chronic diseases; (3) community health service characteristics, such as satisfaction with and accessibility to community health services; and (4) knowledge of chronic diseases. Specifically, women tend to utilize healthcare services more frequently than men. Additionally, residents who are advanced in age, have a family history of chronic diseases, suffer from multiple chronic conditions, rate their self-reported health condition as poor, have a better knowledge about chronic diseases, have better accessibility to community health services, and have higher the satisfaction with community health services, tend to utilize them more frequently.
Given the limited healthcare resources, the government should promote the effective utilization of community health facilities as a critical community-based strategy to combat the growing threat of chronic diseases in southern China. The priority measures involve enhancing residents' access to and satisfaction with community health services and raising awareness of chronic illnesses among older individuals with poor health status.
慢性病负担已成为重大公共卫生问题，高效利用社区卫生服务对于防治慢性病至关重要。本研究描述了中国南方地区慢性病的现状，并探讨了成年居民卫生服务利用的决定因素。
数据来自中国南方赣州市四个县社区调查数据的一部分。采用多阶段、分层随机抽样方法，于 2018 年至 2020 年进行了横断面调查。共收集到 7430 份有效问卷。采用套索线性回归分析探讨社区卫生服务利用的决定因素。
研究结果显示，大多数参与者（44.6%）报告身体状况较好，而 42.1%报告身体状况中等。66.9%的受访者报告患有慢性病。报告的三种最常见的自我报告慢性病为高血压（22.6%）、高血脂（5.9%）和糖尿病（5.9%）。在患有慢性病的居民中，72.1%的居民患有一种慢性病，其余居民患有多种慢性病。只有 13.9%的居民经常利用社区卫生服务，而 18.9%的居民从不利用社区卫生服务。此外，在报告患有慢性病的居民中，14.1%从未到社区卫生服务机构就诊。四类因素是社区卫生服务利用的关键决定因素：（1）个人特征、年龄和性别；（2）健康相关因素，如家族史、自我报告的健康状况和慢性病数量；（3）社区卫生服务特征，如对社区卫生服务的满意度和可及性；（4）慢性病知识。具体而言，女性比男性更倾向于利用医疗保健服务。此外，年龄较大、有慢性病家族史、患有多种慢性病、自我报告健康状况较差、对慢性病知识了解较好、社区卫生服务可及性较高、对社区卫生服务满意度较高的居民更倾向于经常利用社区卫生服务。
鉴于医疗资源有限，政府应促进有效利用社区卫生设施，作为中国南方地区防治慢性病日益威胁的重要社区策略。优先措施包括增强居民对社区卫生服务的获取和满意度，并提高健康状况较差的老年人对慢性病的认识。
