结核病防治纳入新型农村合作医疗前后农村居民卫生服务利用公平性比较研究  

COMPARISON STUDY ON THE EQUALITY OF HEALTH SERVICE UTILIZATION AMONG RURAL RESIDENTS BEFORE AND AFTER BRINGING TUBERCULOSIS INTO NEW RURAL COOPERATIVE MEDICAL SYSTEM

作　　者：刘建涛[1] 李晓英[1] 何燕[1] 

机构地区：[1]河南职工医学院,郑州450003

出　　处：《现代预防医学》2009年第10期1856-1858,共3页Modern Preventive Medicine

摘　　要：[目的]通过对河南省部分地区将结核病防治纳入新型农村合作医疗补偿前后农村居民卫生服务利用公平性比较研究,为改进结核病诊治和管理工作、提高农村居民卫生服务公平性及完善和发展新型农村合作医疗政策提供依据。[方法]采用多阶段分层整群抽样方法,分别对实施结核病防治纳入新型农村合作医疗补偿政策的3个县的农村居民进行问卷调查及访谈,运用集中指数(CI)、不平等斜率(SII)及利用/需要比,结合文献资料,对卫生服务利用公平性进行研究。[结果]与政策实施前相比,实施后调查两周患病就诊率CI由0.0087变为-0.0400,SII由0.0040变为-0.2300;两周患病未就诊率CI由0.1081变为0.0080,SII由0.2710变为0.0240,未住院率CI由-0.3402变为-0.3733,SII由-0.2900变为-0.4200。Spearman等级相关分析与经济状况无显著相关。[结论]新型农村合作医疗对结核病补偿政策的实施,使经济状况较差的农村居民卫生服务利用水平偏低的状况略有改善,有利于提高农村居民卫生服务利用公平性。[Objective] To study the equality of health service utilization among rural residents before and after bringing tuberculosis into new rural cooperative medical system, so as to provide basis for improving the management and treatment of tuberculosis, enhancing the equality of health service for the rural residents and developing the new rural cooperative medical system （NCMS）. [Methods]Multi-phrase stratified clustering randomized sampling was adopted to investigate residents in 3 counties which were brought into new rural cooperative medical system. The concentration index （CI）, slope index of inequity （SII） and utilization to requirement ratio were investigated to evaluate the equity with utilization with literature review. [ Resufts] The CI and SII of see a doctor in the recent two weeks changed from 0.0087 to 0.0400, and 0.0040 to 0.2300 before and after NCMS, respectively. The CI and SII of people who did not see a doctor but need to, changed from 0.1081 to 0.0080, and 0.2710 to 0.0240. The CI and SII of unhospitalization descended from -0.3402 to -0.3733, and -0.2900 to -0.4200, respectively. Spearman conection analysis shinned these indexes had no correlation with economie situation. [ Conclusion] The NCMS has improved the situation of heahh service utilization of the poor rural residents, and it is helpful to improve the equity of health service among rural people.

关 键 词：新型农村合作医疗 结核病 卫生服务利用:公平性 

分 类 号：R52[医药卫生—内科学]