Abstract: Background　Services for the disabled have received wide attention in recent years. On the one hand，due to large disabled population，a considerable number of disabled people can not meet their service demand; on the other hand，with the rapid development of economy，the gap between urban and rural areas is gradually widening. Cerebrovascular disease，as the second most common cause of death in the world，has the characteristic of high incidence and disability rate. In China，the economic burden caused by stroke alone is as high as 40 billion RMB per year.Objective　To investigate the demand and satisfaction of multi-level services in people with disability caused by cerebrovascular disease，and analyze the urban-rural differences，providing references for relevant policy-making. Methods　The data was collected from the Second National Sample Survey on Disability conducted in China in 2006，involving a total of 12 583 individuals with disability caused by cerebrovascular disease. Characteristics including gender，age，marital status，education level，nationality，household income per capita，disability level and place of residence were recorded. The demand，utilization and satisfaction of 13 services 〔composed of health services （typeⅠ service），basic survival services （typeⅡservice），self-promotion and personal development services（typeⅢ service），and environmental support services（type Ⅳservice）〕 in the populations were evaluated. Results　Among the 12 583 participants，7 697 （61.2%） were from rural areas and 4 886 （38.8%） from urban areas. Among the participants from rural areas，the demand rates of type Ⅰ，Ⅱ，Ⅲ and Ⅳ services were 94.6%，75.4%，1.6% and 22.2%，respectively，the corresponding utilization rates were 52.5%，13.0%，0.4% and 8.8%，respectively，and the corresponding satisfaction rates were 44.7%，11.7%，0.1% and 2.8%，respectively. In the participants from urban areas，the demand rates of type Ⅰ，Ⅱ，Ⅲ and Ⅳ services were 94.3%，46.7%，1.4% and 31.5%，respectively，the corresponding utilization rates were 72.8%，7.9%，0.3% and 14.8%，respectively，and the corresponding satisfaction rates were 62.8%，6.3%，0.1% and 6.2%，respectively. The demand，utilization and satisfaction rates of type Ⅱ service in rural participants were significant higher than those in urban participants （P<0.05）． The demand rate of type Ⅳ，the utilization and satisfaction rates of type Ⅰ and Ⅳ in rural participants were significant lower than those of urban participants （P<0.05）． Living in urban areas was associated with a higher satisfaction degree of type Ⅰ service 〔OR=1.665，95%CI（1.527，1.816），P<0.001〕 and type Ⅳ service 〔OR=2.040，95%CI（1.646，2.528），P<0.001〕，but a lower satisfaction degree of typeⅡ service 〔OR=0.769，95%CI（0.662，0.894），P=0.001〕. Conclusion　The demand and satisfaction of health and environmental support services for people with disability caused by cerebrovascular disease in urban areas are higher than those in rural areas. The gap between urban and rural areas should be further narrowed，and the satisfaction of health services in rural areas should be strengthened.

Key words: Cerebrovascular disorders, Disabled persons, Health services needs and demand, Satiety response, Cities, Rural health services

摘要： 背景　近年来，残疾人群服务受到广泛关注。一方面，由于残疾人口规模庞大，导致相当一部分残疾人群的服务需求得不到满足；另一方面，随着经济的快速发展，城乡差异逐渐加大。脑血管疾病是全球人口第二大常见死因，其发病率和致残率均很高。在我国，仅脑卒中这一类脑血管疾病造成的经济负担每年高达400亿元。目的　了解脑血管疾病致残人群的服务需求满足度现状及城乡差异，为相关政策制定提供参考。方法　使用2006年第二次全国残疾人抽样调查数据，选取脑血管疾病致残人群作为研究对象，样本总量为12 583例，统计性别、年龄、婚姻状况、受教育程度、民族、户人均家庭收入、残疾等级、居住地情况。服务包括13项，分为第Ⅰ类为健康服务、第Ⅱ类为基本生存服务、第Ⅲ类为自我提升及发展服务、第Ⅳ类为环境支持性服务，评价脑血管疾病致残人群不同服务的需求、利用、满足情况。结果　12 583例受试者中，乡村7 697例（61.2%），城镇4 886例（38.8%）。乡村第Ⅰ、Ⅱ、Ⅲ、Ⅳ类的需求率分别为94.6%、75.4%、1.6%、22.2%，利用率分别为52.5%、13.0%、0.4%、8.8%，满足度分别为44.7%、11.7%、0.1%、2.8%；城镇第Ⅰ、Ⅱ、Ⅲ、Ⅳ类服务的需求率分别为94.3%、46.7%、1.4%、31.5%，利用率分别为72.8%、7.9%、0.3%、14.8%，满足度分别为62.8%、6.3%、0.1%、6.2%。乡村第Ⅱ类服务需求率、利用率、满足度均高于城镇，第Ⅳ类服务需求率、第Ⅰ、Ⅳ类服务利用率和满足度均低于城镇（P<0.05）。二元Logistic回归分析结果显示，居住地为城镇是第Ⅰ、Ⅳ类服务满足的有利因素〔OR=1.665，95%CI（1.527，1.816），P<0.001；OR=2.040，95%CI（1.646，2.528），P<0.001〕，居住地为城镇是第Ⅱ类服务满足的危险因素〔OR=0.769，95%CI（0.662，0.894），P=0.001〕。结论　城镇脑血管疾病致残人群健康服务、环境支持性服务方面需求、满足度均高于乡村，应进一步缩小城乡差距，加强对乡村脑血管疾病残疾人群健康服务的满足。

关键词: 脑血管障碍, 残疾人, 卫生服务需求, 满足感, 城市, 乡村卫生服务