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[重庆尘肺病患者门诊服务利用情况及其影响因素]

[Utilization of outpatient service of pneumoconiosis patients in Chongqing and its influencing factors].

作者信息

Yang X H, Yang T T, Luo D, Cheng S Q

机构信息

School of Public Health, Chongqing Medical University, Chongqing 401331, China.

Chongqing Occupational Disease Prevention Hospital Occupational Health and Poisoning Emergency Office, Chongqing 400060, China.

出版信息

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2024 Jun 20;42(6):426-432. doi: 10.3760/cma.j.cn121094-20230609-00204.

Abstract

To understand the utilization and characteristics of outpatient services for pneumoconiosis patients within two weeks in Chongqing, and analyze the influencing factors, so as to provide reference for relevant policy making. From October 2020 to October 2022, 1771 pneumoconiosis patients who met the inclusion criteria were selected by multi-stage stratified random cluster sampling. A questionnaire survey was conducted on their basic situation, utilization of outpatient services within two weeks, treatment for pneumoconiosis-related symptoms, and selection of medical service institutions using χ(2)-test and logistic regression analysis. All the 1771 pneumoconiosis patients were male, with the average age of (56.1±10.19) years old. In the pneumoconiosis patients were treated in outpatient department within 2 weeks.40.0% (204/510) of aged 41~50 years Rural patients accounted for 87.8% (448/510) ; 65.1% (332/510) of silicosis patients, 37.5% (191/510) of stage II patients, 75.1% (383/510) of patients did not continue to engage in dust work after diagnosis of pneumoconiosis, and 57.1% (291/510) of patients never had work-related injury insurance at work. The outpatient rate within two weeks of pneumoconiosis related assistance and subsistence allowance was 17.6% (90/510) and 12.5% (64/510), respectively. The average self-health score of the patients was (52.9±16.2). 28.2% of the patients had purchased work-related injury insurance; Among the 1204 patients who received the treatment within two weeks, 42.2% were in the outpatient department, 20.7% were in the inpatient department, and 36.9% were self-buyers. There was a significant difference between the different treatment methods of the patients (χ(2)=27.53, <0.05). There was a significant difference in patients from different residence choosing to visit different medical institutions (χ(2)=13.97, <0.05). The stage of pneumoconiosis, presence of complications, presence of work injury insurance, self-health score, and whether he/she has been hospitalized in the past year are the important factors affecting the outpatient treatment of pneumoconiosis patients. The utilization of outpatient service of pneumoconiosis patients is influenced by demographic sociology, social support and disease characteristics. The quality of occupational disease medical service in primary health institutions should be strengthened so that pneumoconiosis patients can get convenient and effective treatment. Establish a more perfect social security support system to reduce the disease burden of pneumoconiosis patients.

摘要

了解重庆市尘肺病患者两周内门诊服务利用情况及特征,分析其影响因素,为相关政策制定提供参考。2020年10月至2022年10月,采用多阶段分层随机整群抽样方法选取1771例符合纳入标准的尘肺病患者。采用χ²检验和logistic回归分析方法,对其基本情况、两周内门诊服务利用情况、尘肺病相关症状治疗情况及医疗服务机构选择情况进行问卷调查。1771例尘肺病患者均为男性,平均年龄(56.1±10.19)岁。两周内门诊就诊的尘肺病患者中,41~50岁者占40.0%(204/510);农村患者占87.8%(448/510);矽肺患者占65.1%(332/510);Ⅱ期患者占37.5%(191/510);尘肺病确诊后不再从事粉尘作业的患者占75.1%(383/510);工作期间从未有过工伤保险的患者占57.1%(291/510)。尘肺病相关救助金和生活津贴两周内门诊利用率分别为17.6%(90/510)和12.5%(64/510)。患者自我健康评分平均为(52.9±16.2)。28.2%的患者购买过工伤保险;1204例两周内接受治疗的患者中,42.2%在门诊治疗,20.7%在住院治疗,36.9%为自购药治疗。患者不同治疗方式间差异有统计学意义(χ²=27.53,P<0.05)。不同居住地患者选择就诊的医疗机构不同,差异有统计学意义(χ²=13.97,P<0.05)。尘肺病分期、有无并发症、有无工伤保险、自我健康评分及过去一年是否住院是影响尘肺病患者门诊治疗的重要因素。尘肺病患者门诊服务利用受人口社会学、社会支持及疾病特征影响。应加强基层医疗卫生机构职业病医疗服务质量,使尘肺病患者得到便捷有效的治疗。建立更完善的社会保障支持体系,减轻尘肺病患者疾病负担。

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