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慢性病流动人口的就医行为及空间差异:一项全国性的实证研究。

Healthcare-seeking behavior and spatial variation of internal migrants with chronic diseases: a nationwide empirical study in China.

机构信息

United Graduate School of Agricultural Science, Tokyo University of Agriculture and Technology.

College of Economics and Management, Zhengzhou University of Light Industry, Henan Province.

出版信息

Geospat Health. 2024 May 28;19(1). doi: 10.4081/gh.2024.1255.

Abstract

Individuals migrating with chronic diseases often face substantial health risks, and their patterns of healthcare-seeking behavior are commonly influenced by mobility. However, to our knowledge, no research has used spatial statistics to verify this phenomenon. Utilizing data from the China Migrant Dynamic Survey of 2017, we conducted a geostatistical analysis to identify clusters of chronic disease patients among China's internal migrants. Geographically weighted regressions were utilized to examine the driving factors behind the reasons why treatment was not sought by 711 individuals among a population sample of 9272 migrant people with chronic diseases. The results indicate that there is a spatial correlation in the clustering of internal migrants with chronic diseases in China. The prevalence is highly clustered in Zhejiang and Xinjiang in north-eastern China. Hotspots were found in the northeast (Jilin and Liaoning), the north (Hebei, Beijing, and Tianjin), and the east (Shandong) and also spread into surrounding provinces. The factors that affect the migrants with no treatment were found to be the number of hospital beds per thousand population, the per capita disposable income of medical care, and the number of participants receiving health education per 1000 Chinese population. To rectify this situation, the local government should "adapt measures to local conditions." Popularizing health education and coordinating the deployment of high-quality medical facilities and medical workers are effective measures to encourage migrants to seek reasonable medical treatment.

摘要

个体在患有慢性病的情况下迁移往往会面临巨大的健康风险,其医疗服务寻求行为模式通常受到流动性的影响。然而,据我们所知,尚无研究利用空间统计学来验证这一现象。我们利用 2017 年中国流动人口动态监测调查的数据,采用地统计学方法对中国国内迁移的慢性病患者进行了聚类分析。利用地理加权回归模型,研究了 9272 名患有慢性病的移民人群中,711 名未寻求治疗的个体的治疗原因背后的驱动因素。结果表明,中国患有慢性病的国内迁移者存在空间相关性聚类。在东北地区的浙江和新疆,患病率高度聚集。在东北(吉林和辽宁)、北部(河北、北京和天津)以及东部(山东)发现了热点地区,并扩散到周边省份。影响未接受治疗的移民者的因素有每千人口医院床位数、人均医疗保健可支配收入以及每 1000 名中国人口接受健康教育的人数。为了解决这一问题,当地政府应该“因地制宜”。普及健康教育和协调优质医疗设施和医务人员的部署是鼓励移民者寻求合理治疗的有效措施。

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