新型农村合作医疗对农民医疗服务需要与利用影响研究  

A Study of the new-type rural CMS influence on medical service demand and utilization of farmers

作　　者：袁兆康[1] 周小军[1] 方丽霖[1] 万红[2] 肖云昌[2] 周秋生[2] 程红亮 张金泉 

机构地区：[1]江西医学院公共卫生学院,江西南昌330006 [2]江西省卫生厅,江西南昌330006 [3]江西省婺源县卫生局,江西婺源334000

出　　处：《中国农村卫生事业管理》2005年第5期7-10,共4页Chinese Rural Health Service Administration

基　　金：江西省卫生厅科研基金资助

摘　　要：目的:通过基线调查与实施1年后跟踪调查的比较,评价新型农村合作医疗的实施对农民医疗服务需要和利用的影响,为正确认识和科学调整新型农村合作医疗的实施方案提供依据。方法:采用分层整群随机抽样法抽取婺源县3个乡镇9个行政村,每村70户农户,采取入户调查的方式,对农村居民家庭健康状况,医疗服务需要和利用及其影响因素进行了基线调查和1年后的跟踪调查。结果:两次调查农民的性别和年龄分布均无显著差异( P>0 .0 5 ) ,本次调查两周患病率、年住院率和半年慢性病患病率分别为135 .86‰、4 7.70‰、10 6 .0 4‰,与基线调查相比,均无显著差异( P>0 .0 5 )。而就诊率、应就诊未就诊率和应住院未住院率分别为112 .2 9‰、16 .93%、2 4 .0 6 % ,两周卧床率及休工(学)率分别为4 .6 9‰和8.0 9‰,与基线调查相比两周就诊率显著提高,应就诊未就诊率、应住院未住院率、两周卧床率及休工(学)率显著下降( P<0 .0 5 )。因病致贫比例由4 7.6 2 %下降到2 7.78%。因经济困难未就诊的比例由4 7.9%下降到35 .2 % ,因经济困难未住院的比例由78.0 %下降到6 8.8%。结论:新型农村合作医疗实施1年后,卫生服务需要无显著变化,农民的就诊意识有所提高,门诊及住院服务利用有所增加,健康状况有所好转,因病致贫比例下降,但造成农民?Objective Through comparing the base-line investigation and the follow-up investigation after the new-type rural cooperative medical system (CMS) was implemented one year , appraising it influence on medical service demand and utilization of farmers and its influential factors and offering the basis for understanding correctly and adjusting implementing scheme of the new-type rural CMS scientifically. Methods We adopted stratified cluster random sampling to choose 3 townships , 9 administrative villages in Wuyuan county, 70 households in every village, through the way to investigate into each household,we carried out the base-line investigation and follow-up investigation one year after into the health status of rural resident's family, demand and utilization of medical service and the influential factors. Results The farmer sex and age distribution og the base-line investigation and the follow-up investigation have no significant difference (P> 0. 05), the follow-up investigation shows that the two-week prevalence rate is 135.86‰,annual impatient rate is 47.70‰ and half-a-year chronic disease rate is 106.04‰ ,there is no obvious difference from shown the base-line investigation (P>0.05).And proportion of persons going to see a doctor, of persons who respectively not go to see a doctor and are not hospitalized are 112.29‰,16.93%, 24.06%, lying in bed rate and stop working (studying ) rate of the two weeks are 4.69% and 8. 09%. Respectively compared with the results of base-line investigation, proportion of persons going to see a doctor rose significantly, but the other results all dropped significantly (P<0. 05). The proportion of the poor due to illness dropped from 47.62%to 27.78%. The proportion of persons who not go to see a doctor because of financial difficulties dropped from 47.9% to 35.2%. The proportion of persons who are not hospital becauseized of financial difficulties dropped from 78.0% to 68.8%.Conclusion After new-type rural CMS has been implemented one year, demand for of medical se

关 键 词：卫生服务需要 卫生服务利用 新型农村合作医疗 

分 类 号：R197.1[医药卫生—卫生事业管理] R195[医药卫生—公共卫生与预防医学]