城镇贫困居民卫生服务需要和利用分析及将社区家庭病床纳入医疗救助体系的讨论  

Analysis of Need and Utilization of Health Service for the Urban Poor Residents and Discussion on Bringing Community Family Bed into Medical Assistance System

作　　者：杨晓虹[1] 任晓晖[2] 黄小明[3] 吴义丽[4] 

机构地区：[1]成都医学院,四川成都610083 [2]四川大学华西公共卫生学院 [3]四川省宜宾卫生学校 [4]青岛大学医学院

出　　处：《中国卫生事业管理》2007年第8期508-510,共3页Chinese Health Service Management

摘　　要：目的:通过对城镇社区人群卫生服务需要和利用的影响因素,卫生服务机构利用情况,以及医疗负担进行分析,旨在为各级卫生决策部门提供贫困居民医疗救助政策支持。方法:采取分层整群随机抽样,问卷访谈,logistic回归和卡方检验。结果:影响两周患病的因素有家庭类型(P<0.05);影响慢性病患病率的因素有是否有医疗保障及家庭类型(P<0.05);在选择就诊机构上,困难居民到大医院的比例明显低于普通居民,困难居民及享受医疗救助的居民倾向利用社区卫生服务中心;自付住院医疗费用的来源,有47.70%的困难居民需要依赖借贷或资助基金,这一比例远高于普通居民(14.80%)(χ2=28.177,P<0.05)。结论:困难人群对卫生服务的需要较高,利用却相对较低,迫切的需要一个良好的医疗救助体制的建立和实施,其实施过程需加强社区卫生服务中家庭病床在医疗救助中的作用并规范家庭病床的管理。Objectives Through analyzing the influential faetors of need and utilization of health service for urban residents, using health service institutes and medical burden, to supply some referenees for health administrative department formulating medical assistance policies. Methods The stratified duster sampling method was used. We interviewed with the residents with the questionnaire, and analyzed the data with logistic regression and χ^2 test. Results The influential factor of two - week prevalence rate was type of family （ P 〈 0.05）. The influential factors of chronic prevalence rate were medical insurance and type of family （P 〈 0.05）. The proportion of choosing general hospitals for poor residents was lower than that of common residents. The poor residents and those who enjoyed medical assistance preferred to community health service center. For the sources of out - of- pocket, the 47.7 % poor residents depended on loan or assistance fund, which was higher than that of common residents （ χ^2= 28.177, P 〈 0.05）. Conclusions The health service need for the poor residents is higher, hut the utilization is relatively lower. It is urgent to establish medical assistance system. It needs to reinforce the role of family bed in medical assistance and it also should standardize family bed management.

关 键 词：城镇居民 卫生服务需要和利用 家庭病床 医疗救助 

分 类 号：R197.1[医药卫生—卫生事业管理]