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目的探讨广东省广州市和中山市农村社区居民常见慢性非传染性疾病就诊取向,为制定社区综合防治干预措施提供科学依据。方法在广州市某区和中山市某镇分别随机抽取20 264名及3 278名农村居民进行问卷调查,分析2市农村居民慢性病就诊取向及其主要影响因素。结果广州市和中山市农村居民慢性病患病率分别为12.43%和9.43%;广州、中山2市分别有49.2%和65.7%的居民选择在区医院或二级医院就诊,广州市居民(25.9%)选择在三级综合或专科医院就诊的比例明显高于中山市居民(3.9%)(P<0.05);2地在社区卫生服务机构就诊比例普遍偏低,分别为14.6%和29.1%,在企事业单位医院/保健站及其他医疗机构就诊比例为10.2%和1.3%;影响就诊取向因素主要有年龄(OR=1.138)、职业(OR=1.050)、体育锻炼(OR=0.508)、保健知识(OR=1.825)。结论农村居民慢性病在基层医疗就诊比例较低,应积极引导农村社区慢性病患者向社区卫生服务机构就诊,并开展社区慢性病规范化管理。
Objective To explore the treatment orientation of common chronic non-communicable diseases in rural community residents in Guangzhou City and Zhongshan City of Guangdong Province, and to provide a scientific basis for formulating community comprehensive prevention and treatment interventions. Methods A total of 20 264 and 3 278 rural residents were randomly selected from a district in Guangzhou and a town in Zhongshan to conduct a questionnaire survey to analyze the orientation and main influencing factors of rural residents’ chronic diseases in two cities. Results The prevalence rates of chronic diseases among rural residents in Guangzhou and Zhongshan were 12.43% and 9.43% respectively. Residents in Guangzhou and Zhongshan 2, with 49.2% and 65.7% respectively, chose to visit the district hospital or secondary hospital. Guangzhou residents (25.9% ) Were significantly higher than those in Zhongshan (3.9%) (P <0.05). The proportion of community health service visits in the two areas was generally low, at 14.6% and 29.1%, respectively. There were 10.2% and 1.3% of the medical and hospital treatment stations in hospitals, clinics and health centers and other medical institutions, respectively. The main factors influencing the orientation of medical treatment were age (OR = 1.138), occupation (OR = 1.050), physical exercise (OR = 0.508) (OR = 1.825). Conclusion The proportion of rural residents with chronic diseases in primary care is relatively low. Patients with chronic diseases in rural communities should be actively guided to community health service institutions and standardized management of community chronic diseases.