农村成人乙肝疫苗接种可及性研究-中国卫生事业管理.docVIP

农村成人乙肝疫苗接种服务可及性研究( 刘彩 摘要：目的 探讨农村成人乙肝疫苗接种服务可及性，为提高接种率提供依据。方法 采用多阶段概率比例规模抽样抽取保定和石家庄市16岁至60岁成人4020人问卷调查。结果 随到最近接种机构时间增加，乙肝疫苗接种率降低；家庭人均年收入高和自感经济状况改善组接种率也高，价格是主要阻碍因素之一；认知水平显著影响接种行为，村医和村卫生室是接种信息主要来源之一和主要接种机构。结论 应通过新农合政策等提高经济可及性，改变村医激励机制，发挥其天然优势和作用。 关键词：乙肝疫苗；可及性；农村；成人 Study on Accessibility of Hepatitis B Vaccination Service of Adults in Rural Areas LIU Cai, Faculty of public services management, School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, 300073, China. Abstract: Objective To explore accessibility of Hepatitis B vaccination service of adults in rural areas and propose evidence for improvement of coverage rate. Method 4020 adults aged 16~60 years old were selected from 12 villages in 4 counties by probability proportionate to size sampling in Baoding and Shijiazhuang city, investigated them using questionnaire. Results With more time to reach the nearest injection institution, coverage rate of Hepatitis B vaccination is lower; coverage rate of Hepatitis B vaccination is higher in group of high-income and better self-evaluation economic status, and price is one of the factors hampering vaccination; cognition level affects vaccination behavior significantly and village doctors and village clinics are the main information source and injection institution. Conclusion New Rural Cooperative Medical Scheme should be applied to improve economic accessibility and incentive mechanism should be changed to take village doctors’ natural advantage. Keywords: Hepatitis B vaccine; accessibility; rural area; adults First-author’s address: Management School, Tianjin University of Chinese Traditional Medicine, Tianjin, 300073, China. 世界卫生组织2000年卫生报告中把卫生服务可及性解释为：实现居民最基本医疗卫生需求的难易程度，即居民到医疗卫生机构的方便程度[1]。美国健康学会2004年版卫生保健术语词汇表可及性定义为个人获得适当的卫生保健服务的能力认为可及性的障碍有4种：经济方面（缺钱）、地理方面（距离远）、组织方面（缺服务机构）、社会方面（歧视和语言障碍）。龚幼龙教授认为卫生服务可及性是论述卫生服务对象具备接受服务的能力可从地理、经济和服务3方面论述成人接种乙肝疫苗有良好免疫效果、经济和社会效益[]。 1 对象与方法 1.1 对象 按经济发展水平和地理位置，在石家庄和保定市分别抽取2个县，每个县抽3个村。采用多阶段概率比例规模抽样方法，在每个村抽取住户调查。本研究关注1