Hospitalized but not admitted and influencing factors for pneumoconiosis patients
10.3760/cma.j.issn.1001-9391.2019.09.016
- VernacularTitle: 尘肺病患者的应住院未住院情况及影响因素分析
- Author:
Huanqiang WANG
1
;
Gang CHEN
2
;
Ying LI
3
;
Ping CUI
4
;
Guangfeng LIU
4
;
Xiangpei LV
1
;
Ke WEN
1
Author Information
1. National Institute of Occupational Health and Poison Control, China Center for Disease Control and Prevention, Beijing 10050, China
2. Beidaihe Rehabilitation Hospital of Ministry of Emergency Management of the PRC, Qinhuangdao 066104, China
3. Hunan Prevention and Treatment Center for Occupational Disease, Changsha 410007, China
4. Shandong Academy of Medical Science, Shandong Academy of Occupational Medicine, Jinan250002
- Publication Type:Case Reports
- Keywords:
Pneumoconiosis;
Hospitalization;
Health services
- From:
Chinese Journal of Industrial Hygiene and Occupational Diseases
2019;37(9):696-702
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the situation where pneumoconiosis patients who should be in hospital are not hospitalized, to analyze the main reasons and influencing factors for their restricted use of hospitalization medical services, and to provide a reference for relevant policy making.
Methods:Subjects were sampled in nine provinces, including Zhejiang, Jiangsu, Shandong, and Hebei, using a method that combined stratified sampling and typical sampling, from March 2017 to January 2018. These subjects were patients occupationally diagnosed with pneumoconiosis and patients clinically diagnosed with pneumoconiosis. The questionnaire The health seeking behaviors of pneumoconiosis patients and their influencing factors was used as the survey tool to investigate their health seeking behaviors such as going to the outpatient clinic and being hospitalized. Andersen's Behavioral Model of Health Services Use was used as the analysis model; The χ2 test was used for univariate analysis, and the multivariate logistic regression model was used for multivariate analysis.
Results:A total of 1 037 patients with pneumoconiosis were surveyed, with a mean age of 55.9±11.2 years and 67.5% (700/1 037) living in rural areas for a long time. Occupational injury insurance and medical insurance for urban and rural residents were the main insurances used, accounting for 40.9% (424/1 037) and 59.4% (616/1 037) of the cases, respectively. A total of 177 (17.1%) patients were once advised by the doctors to be hospitalized because of pneumoconiosis, while they did not. The proportion of patients who should be in hospital but did not do so among rural patients was significantly higher than that in urban patients (20.1% (141/700) vs 10.7% (36/337) , P<0.05) . Financial difficulties (12.0%, 124/1 037) and self-rated mild symptoms (3.2%, 33/1 037) were the main reasons for not being hospitalized. Model analysis showed that the propensity factor, ability factor, health needs, health seeking behaviors, and self-rated health factor in the Anderson model were all statistically significant (P<0.05) . The main features of high proportion of patients who should be in hospital but did not do so were as follows: personal monthly income below 1 000 RMB (odds ratio[OR]of no income=2.92, 95% confidence interval[CI]: 1.14-7.48; OR of less than 1 000 RMB=3.55, 95%CI: 1.35-9.35) , no occupational injury insurance (OR=2.05, 95%CI: 1.16-3.43) , and concurrent emphysema (OR= 1.98, 95%CI: 1.12-3.50) .
Conclusion:Low income, no occupational injury insurance, and concurrent emphy-sema are the main constraining factors for hospitalization services use in pneumoconiosis patients.
