高温天气下疾病加重情况及其未就诊的影响因素分析
|
摘要
目的了解高温条件下居民疾病加重情况及疾病加重后未就诊的影响因素,为改善居民健康状况提供科学依据。方法利用2012-2013年在海南省调查的"海南省居民高温天气感受和适应"的调查数据,描述不同疾病在高温天气下是否加重,并对可能影响未就诊的因素采用χ~2检验、Fisher单因素检验及多因素logistic回归模型分析。结果心血管疾病、呼吸系统疾病、糖尿病患者在高温天气下都存在疾病加重现象,加重比例分别为46%、42.70%、66%,这些疾病加重患者中未就诊比例为45.10%、31.30%、38.10%;多因素logistic回归分析显示,健康风险感知高、经常接受健康宣教、公费医疗就诊可能性较大,而文化程度高就诊可能性小。结论高温条件下原有疾病加重率、未就诊比例较高,为提高高温条件下居民健康水平及卫生服务利用率,需要加强健康宣传教育,提高医保覆盖面,并进一步提高居民高温健康风险意识。
Objective To understand the status of aggravation of diseases which residents have got under the high temperature condition,to research the influencing factors of no clinical visit,and to provide scientific basis for improving the health status of residents.Methods The data was collected from the project of Public Perceptions and Adaptation for Heat Risks to Human Health in Hainan Province during 2012 to 2013 to describe the status of diseases.The influence factors of not seeking diagnosis were analyzed by χ~2 test,Fisher Exact Probability method and the model of Multiple-factor Logistic Regression.Results Cardiovascular diseases,respiratory diseases and diabetes all got aggravated in high temperature,with the aggravation rates of 46%,42.70% and 66%,respectively.Among those patients,the proportion of not seeking diagnosis were 45.10%,31.30%,and 38.10%,respectively.Multivariate Logistic Regression analysis showed that patients with higher health risk perception,more health education and better public health services were more likely to visit doctor,while patients with higher degree of education might not likely to get diagnosis.Conclusion Under the condition of high temperature,the original disease aggravation rate and the proportion of not seeing a doctor are higher.In order to improve the level of health and the utilization rate of health service,it's necessary to strengthen the education of health,improve the comprehensive health care,and enhance the health consciousness will.
Objective To understand the status of aggravation of diseases which residents have got under the high temperature condition,to research the influencing factors of no clinical visit,and to provide scientific basis for improving the health status of residents.Methods The data was collected from the project of Public Perceptions and Adaptation for Heat Risks to Human Health in Hainan Province during 2012 to 2013 to describe the status of diseases.The influence factors of not seeking diagnosis were analyzed by χ~2 test,Fisher Exact Probability method and the model of Multiple-factor Logistic Regression.Results Cardiovascular diseases,respiratory diseases and diabetes all got aggravated in high temperature,with the aggravation rates of 46%,42.70% and 66%,respectively.Among those patients,the proportion of not seeking diagnosis were 45.10%,31.30%,and 38.10%,respectively.Multivariate Logistic Regression analysis showed that patients with higher health risk perception,more health education and better public health services were more likely to visit doctor,while patients with higher degree of education might not likely to get diagnosis.Conclusion Under the condition of high temperature,the original disease aggravation rate and the proportion of not seeing a doctor are higher.In order to improve the level of health and the utilization rate of health service,it's necessary to strengthen the education of health,improve the comprehensive health care,and enhance the health consciousness will.
引文
[1] 李永红,兰莉,程义斌,等.哈尔滨市某城区高温敏感疾病和脆弱人群的粗筛[J].环境卫生学杂志,2014(4):321-324,330.
[2] 林巧绚.基于死亡风险评估的中国不同区域热浪定义及其死亡负担研究[D].广州:暨南大学,2017.
[3] Ge YH,Liu C,Niu YE,et al.Associations between ambient temperature and daily hospital admissions for rheumatic heart disease in Shanghai,China[J].International Journal of Biometeorology,2018,62(12):2189-2195.
[4] Zhang YE,Yan CY,Kan HD,et al.Effect of ambient temperature on emergency department visits in Shanghai,China:a time series study[J].Environmental Health,2014,13(1):100-107.
[5] Yang LT,Chang YM,Hsieh TH,et al.Associations of ambient temperature with mortality rates of cardiovascular and respiratory diseases in Taiwan:a subtropical country[J].Acta Cardiologica Sinica,2018,34(2):166-174.
[6] 王金玉,李盛,李普,等.2014-2017年兰州市气温与死亡人数关系的时间序列研究[J].环境与职业医学,2018,35(12):1076-1082.
[7] Basu R,Ostro BD.A multicounty analysis identifying the populations vulnerable to mortality associated with high ambient temperature in California[J].American Journal of Epidemiology,2008,168(6):632-637.
[8] 郭亮,王烨菁,贾晓东,等.气温对上海市某中心城区医院急诊内科就诊量的影响[J].环境与职业医学,2017,34(4):321-325.
[9] 郑山,王敏珍,尚可政,等.高温热浪对北京3所医院循环系统疾病日急诊人数影响的病例-交叉研究[J].卫生研究,2016,45(2):246-251.
[10] Percic S,Kukec A,Cegnar T,et al.Number of heat wave deaths by diagnosis,sex,age groups,and area,in Slovenia,2015 vs.2003[J].International Journal of Environmental Research & Public Health,2018,15(1):173.
[11] 唐少霞,赵志忠,毕华,等.海南岛气候资源特征及其开发利用[J].海南师范大学学报(自然科学版),2008,21(3):343-346.
[12] 吴凡,景元书,李雪源,等.南京地区高温热浪对心脑血管疾病日死亡人数的影响[J].环境卫生学杂志,2013(4):288-292.
[13] 谈建国,黄家鑫.热浪对人体健康的影响及其研究方法[J].气候与环境研究,2004,9(4):680-686.
[14] Lam HC,Li AM,Chan EY.The short-term association between asthma hospitalisations,ambient temperature,other meteorological factors and air pollutants in Hong Kong:a time-series study[J].Thorax,2016,71(12):1097-1109.
[15] 翟文慧.气候因子和空气污染物与哮喘急诊就医的关系研究[D].北京:中国人民解放军医学院,2014.
[16] Holmén A,Blomqvist J,Frindberg H,et al.Frequency of patients with acute asthma in relation to ozone,nitrogen dioxide,other pollutants of ambient air and meteorological observations[J].International Archives of Occupational and Environmental Health,1997,69(5):317-322.
[17] Hess J,Darrow L,Klein M,et al.15:Impact of daily pollen levels on emergency department visits for asthma[J].Annals of Emergency Medicine,2010,56(3):S5-S6.
[18] 赵文晓,陈莉军,刘艳丽.居民就医行为与社区卫生服务中心利用情况的调查[J].护理研究,2009,23(22):2058-2059.
[19] Bhojani U,Beerenahalli TS,Devadasan RA,et al.No longer diseases of the wealthy:prevalence and health-seeking for self-reported chronic conditions among urban poor in Southern India[J].BMC Health Services Research,2013,13(1):1-10.
[20] 方磊,胡伟,张宝芳,等.广东省英德市15岁及以上居民就诊率及影响因素分析[J].中国初级卫生保健,2018,32(2):3-5.
[21] 姚萱,赵延芳,杨红,等.基于定序logistics回归模型下乌鲁木齐市居民社区卫生服务利用影响因素分析[J].中国卫生事业管理,2016,33(6):413-415,432.
[22] 杨文燕.山东省农村居民健康素养评价及其与卫生服务利用的关系研究[D].济南:山东大学,2014.
[23] 徐玉洁,周芬,谢红莉.农村居民健康素养状况调查及影响因素分析[J].中国初级卫生保健,2010,24(11):1-3.
[24] 王克英,崔甍甍,张进军.气象因素对脑血管疾病急性发病影响的病例交叉研究[J].中国全科医学,2015(22):2662-2666.
[25] 何贤省,蒋峻.浙江省台州市极端高温和低温对心脑血管疾病死亡的影响分析[J].疾病监测,2018,33(7):609-613.
[2] 林巧绚.基于死亡风险评估的中国不同区域热浪定义及其死亡负担研究[D].广州:暨南大学,2017.
[3] Ge YH,Liu C,Niu YE,et al.Associations between ambient temperature and daily hospital admissions for rheumatic heart disease in Shanghai,China[J].International Journal of Biometeorology,2018,62(12):2189-2195.
[4] Zhang YE,Yan CY,Kan HD,et al.Effect of ambient temperature on emergency department visits in Shanghai,China:a time series study[J].Environmental Health,2014,13(1):100-107.
[5] Yang LT,Chang YM,Hsieh TH,et al.Associations of ambient temperature with mortality rates of cardiovascular and respiratory diseases in Taiwan:a subtropical country[J].Acta Cardiologica Sinica,2018,34(2):166-174.
[6] 王金玉,李盛,李普,等.2014-2017年兰州市气温与死亡人数关系的时间序列研究[J].环境与职业医学,2018,35(12):1076-1082.
[7] Basu R,Ostro BD.A multicounty analysis identifying the populations vulnerable to mortality associated with high ambient temperature in California[J].American Journal of Epidemiology,2008,168(6):632-637.
[8] 郭亮,王烨菁,贾晓东,等.气温对上海市某中心城区医院急诊内科就诊量的影响[J].环境与职业医学,2017,34(4):321-325.
[9] 郑山,王敏珍,尚可政,等.高温热浪对北京3所医院循环系统疾病日急诊人数影响的病例-交叉研究[J].卫生研究,2016,45(2):246-251.
[10] Percic S,Kukec A,Cegnar T,et al.Number of heat wave deaths by diagnosis,sex,age groups,and area,in Slovenia,2015 vs.2003[J].International Journal of Environmental Research & Public Health,2018,15(1):173.
[11] 唐少霞,赵志忠,毕华,等.海南岛气候资源特征及其开发利用[J].海南师范大学学报(自然科学版),2008,21(3):343-346.
[12] 吴凡,景元书,李雪源,等.南京地区高温热浪对心脑血管疾病日死亡人数的影响[J].环境卫生学杂志,2013(4):288-292.
[13] 谈建国,黄家鑫.热浪对人体健康的影响及其研究方法[J].气候与环境研究,2004,9(4):680-686.
[14] Lam HC,Li AM,Chan EY.The short-term association between asthma hospitalisations,ambient temperature,other meteorological factors and air pollutants in Hong Kong:a time-series study[J].Thorax,2016,71(12):1097-1109.
[15] 翟文慧.气候因子和空气污染物与哮喘急诊就医的关系研究[D].北京:中国人民解放军医学院,2014.
[16] Holmén A,Blomqvist J,Frindberg H,et al.Frequency of patients with acute asthma in relation to ozone,nitrogen dioxide,other pollutants of ambient air and meteorological observations[J].International Archives of Occupational and Environmental Health,1997,69(5):317-322.
[17] Hess J,Darrow L,Klein M,et al.15:Impact of daily pollen levels on emergency department visits for asthma[J].Annals of Emergency Medicine,2010,56(3):S5-S6.
[18] 赵文晓,陈莉军,刘艳丽.居民就医行为与社区卫生服务中心利用情况的调查[J].护理研究,2009,23(22):2058-2059.
[19] Bhojani U,Beerenahalli TS,Devadasan RA,et al.No longer diseases of the wealthy:prevalence and health-seeking for self-reported chronic conditions among urban poor in Southern India[J].BMC Health Services Research,2013,13(1):1-10.
[20] 方磊,胡伟,张宝芳,等.广东省英德市15岁及以上居民就诊率及影响因素分析[J].中国初级卫生保健,2018,32(2):3-5.
[21] 姚萱,赵延芳,杨红,等.基于定序logistics回归模型下乌鲁木齐市居民社区卫生服务利用影响因素分析[J].中国卫生事业管理,2016,33(6):413-415,432.
[22] 杨文燕.山东省农村居民健康素养评价及其与卫生服务利用的关系研究[D].济南:山东大学,2014.
[23] 徐玉洁,周芬,谢红莉.农村居民健康素养状况调查及影响因素分析[J].中国初级卫生保健,2010,24(11):1-3.
[24] 王克英,崔甍甍,张进军.气象因素对脑血管疾病急性发病影响的病例交叉研究[J].中国全科医学,2015(22):2662-2666.
[25] 何贤省,蒋峻.浙江省台州市极端高温和低温对心脑血管疾病死亡的影响分析[J].疾病监测,2018,33(7):609-613.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |