| 张静,刘民.广东、河南、甘肃三省1 2县区腹泻病例就诊模式调查[J].Chinese journal of Epidemiology,2008,29(10):989-993 |
| 广东、河南、甘肃三省1 2县区腹泻病例就诊模式调查 |
| Current situation on the treatment modules of diarrhea cases in 12 counties/cities of Guangdong,Henan and Gansu provinces in China |
| Received:July 08, 2008 |
| DOI： |
| KeyWord: 腹泻 发病率 就诊率 疾病负担 流行病学调查 |
| English Key Word: Diarrhea Incidence rate Percentage for visiting doctor for disease treatment Disease burden Epidemiological investigation |
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| Abstract: |
| 目的 了解当前中国腹泻病例的就诊率及就诊机构,为制定相关卫生政策提供参考依据.方法 按照多阶段分层随机整群抽样方法,在东、中、西部分别选取广东、河南、甘肃省,抽取12个县区60个居委会/村,采用WHO对腹泻病例的定义,分别于4个季节进行腹泻发病及就诊情况的入户调查. 结果 广东、河南、甘肃三省12个县区人群平均两周腹泻发病率为0.79%(95%CI:0.74%～0.84%),5岁以下儿童的两周腹泻发病率为2.30%(95%CI:1.96%～2.67%),明显高于其他年龄组.两周腹泻就诊率为55.89%(95%CI:52.90%～58.84%),以5岁以下儿童腹泻就诊率最高(79.88%),城市腹泻病例就诊率(40.76%)显著低于农村(65.25%),不同季节、不同年龄组的就诊率也有所不同.城市中腹泻病例到街道卫生所/社区卫生服务中心的就诊比例最高(35.38%),农村居民腹泻病例到村卫生室/个体诊所处的就诊率最高(75.04%).用logistic回归方法进行腹泻就诊影响冈素分析, 结果 显示农村较城市腹泻就诊例数增加;米泔水样便、水样便较有黑便的腹泻病例就诊例数增加;发热较不发热病例就诊例数增加;腹泻持续天数越长、腹泻每日次数越多就诊例数越多;参加合作医疗较无医疗保险的腹泻病例就诊例数增加;第2、4季度就诊例数较第1季度增加. 结论 目前城乡腹泻病例就诊模式小同,城市腹泻病例就诊率低于农村,城乡总的腹泻病例就诊率以及5岁以下儿童腹泻就诊率较20年前有所提高. |
| English Abstract: |
| Objective To understand the situation of diarrhea cases treatment modules in the areas and to provide referencc data for setting up national strategies for treatment and control of diarrhea diseases.Methods Using the method of multistage and cluster random sampling,we selected twelve counties/cities and 60 streets communities/villages from Guangdong,Henan and Gansu provinces that representing three kinds of economic development．According to the definition of diarrhea case published by World Health Organization,we conducted a four-time investigation at the community level in four different sessons.Results The overall incidence of diarrhea within two weeks was 0.79％(95％CJ:0.74％-0.84％)in the residents from twelve counties/districts in Guangdong．Henan and Gansu.The incidence rate within two weeks under the 5 years old was 2.30％(95％CI:1.96％-2.67％),obviously higher than the incidence rates seen in other age groups.The average percentage of visiting a doctor seeking for help on diarrhea within the two weeks was 55.89％ for the three provinces.The highest percentage was 79.88％ in the age group under 5 years old.35.38％ of the patients with diarrhea in urban area went to the community or street clinics for treatment.but 75.04％of the diarrhea cases in rural areas went to see village or private rural doctors．Factors influencing the behaviors of visiting a doctor seeking for help were found by logistic Regression method.It was found that factors as:when diarrhea cases with voluminous or soft-rice like watery stools or with dark blood stools;when a patient was with fever,more episodes per day or with longer duration,the patients would turn more to the doctors for help.Diarrhea cases from the rural areas would see doctors more often than the cases from the urban areas.People having had partial 'new rural medicalinsurance' would see doctors more often than those without medical insurance.Conclusion We studied the modules of diarrhea case treatment between the urban and rural areal in Guangdong,Henan and Gansu provinces and found that the percentages of visiting a doctor for diarrhea treatment in the rural areas was higher than that in the urban areas.Both residents at all age and under 5 years old,the percentage of visiting a doctor for diarrhea treatment showed a sharp increase in the last two decades. |
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