阜阳地区慢性肾脏病疾病谱与健康服务利用现况调查

doi:10.12183/j.scjpm.2026.0572

摘要/Abstract

摘要： 目的调查阜阳地区成年人慢性肾脏病（CKD）疾病谱与健康服务利用现况及其影响因素。方法抽取2021年10月至2025年5月于阜阳地区若干医疗机构就诊的1 014例CKD患者为调查对象。分析疾病谱特征,围绕筛查与知晓、就诊行为、资源利用3个维度评估健康服务利用情况;经单、多因素分析方法探讨本地区成人CKD健康服务利用率的影响因素。结果阜阳地区地区CKD疾病谱中,CKD以继发性肾病为主（89.4%）,其中糖尿病肾病占比最高（42.01%）,其次为高血压肾病、高尿酸性肾病等;疾病分期以3期居多（55.03%）;常见共病为心脑血管疾病（68.15%）为主。健康服务方面,84.42%患者知晓CKD相关服务,首诊以县医院为主,医保实际报销≥ 60%占61.42%,灾难性卫生支出发生率21.30%。多因素logistic回归分析显示年龄（年龄越低OR=1.688）、家庭年收入（收入越高OR=2.954）、受教育程度（越高OR=1.594）、社区健康服务供给（有供给OR=3.771）、上网方便程度（方便OR=2.118）、社会支持度（中等/高OR=4.809）、疾病不确定感（中等/弱OR=4.068）是阜阳地区成人CKD健康服务利用率的影响因素（均P< 0.05）。结论阜阳地区成人CKD以继发性肾病、中期患者及共病多见。健康服务整体利用率较好,但也存在知晓不足、就诊延迟等问题;年龄、家庭年收入、受教育程度、社区健康服务供给、上网方便程度、社会支持度及疾病不确定感是影响该地区CKD健康服务利用率的主要因素。

关键词: 慢性肾脏病, 疾病谱, 健康服务, 利用率, 影响因素

Abstract: Objective To investigate the disease spectrum of chronic kidney disease (CKD), the current utilization of health services, and its associated determinants among adults in the Fuyang region. Methods A total of 1 014 patients with CKD, treated at various medical institutions in the Fuyang region between October 2021 and May 2025, were enrolled in this study. The investigation involved analyzing the characteristics of the disease spectrum and assessing health service utilization across three dimensions: screening and awareness, health-seeking behavior, and resource utilization. Univariate and multivariate analyses were subsequently employed to identify the factors influencing the rate of health service utilization for adult CKD in this locality. Results The disease spectrum of CKD in the Fuyang region was predominantly characterized by secondary nephropathy (89.4%), with diabetic nephropathy constituting the largest proportion (42.01%), followed by hypertensive nephropathy and hyperuricemic nephropathy. The majority of patients were in stage 3 of the disease (55.03%), and cardiovascular and cerebrovascular diseases were the most prevalent comorbidities (68.15%). Regarding health services, 84.42% of patients were aware of CKD-related services. The initial consultation typically occurred at county-level hospitals. The actual medical insurance reimbursement rate was ≥60% for 61.42% of patients, and the incidence of catastrophic health expenditure was 21.30%. Multivariate logistic regression analysis revealed that age (younger age, OR=1.688), annual family income (higher income, OR=2.954), educational attainment (higher level, OR=1.594), availability of community health services (available, OR=3.771), convenience of internet access (convenient, OR=2.118), level of social support (moderate/high, OR=4.809), and illness uncertainty (moderate/low, OR=4.068) were significant determinants of health service utilization among adults with CKD in the Fuyang region (all P<0.05). Conclusion The adult CKD population in the Fuyang region is primarily characterized by secondary nephropathy, mid-stage disease, and a high prevalence of comorbidities. While the overall utilization of health services is relatively favorable, issues such as insufficient awareness and delays in seeking medical consultation persist. The principal factors influencing health service utilization in this population include age, annual family income, educational attainment, availability of community health services, internet accessibility, social support, and the degree of illness uncertainty.

Key words: Chronic kidney disease, Disease spectrum, Health services, Utilization rate, Influencing factors

中图分类号:

R195

甄贞, 邢建, 赵峰. 阜阳地区慢性肾脏病疾病谱与健康服务利用现况调查[J]. 华南预防医学, 2026, 52(5): 572-576.

Zhen Zhen, Xing Jian, Zhao Feng. A survey on the disease spectrum and health service utilization for chronic kidney disease in Fuyang[J]. South China Journal of Preventive Medicine, 2026, 52(5): 572-576.

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