从农民卫生服务需求看新农合制度的设计  

Design of New Rural Cooperative Medical System based on Health Service Demand

作　　者：韩颖[1] 张泽[2] 郑建中[1] 

机构地区：[1]山西医科大学公共卫生学院,山西太原030001 [2]山西省太原市卫生局,山西太原030001

出　　处：《中国农村卫生事业管理》2009年第8期587-590,共4页Chinese Rural Health Service Administration

摘　　要：目的:比较不同地区农民卫生服务需求特征,研究不同社会、经济文化背景下新农合制度的设计。方法:选取新农合试点的太原市城区(迎泽区、万柏林区、杏花岭区和尖草坪区)和农村(娄烦县),利用家庭健康询问调查,收集农民卫生服务需要资料,比较城乡农民卫生服务需要特点,研究其影响因素。结果:城乡农民所处社会经济环境不同,社会人口学特征有显著差异;城乡农民卫生服务需要差别显著,娄烦县农民两周患病和慢性病患病率高于城区农民(P<0.001),两周患者平均卧床天数是城区农民的16.75倍。结论:贫困农村地区居民卫生服务需要量大、筹资能力低,为加强新农合在贫困地区的可持续发展,建议以地市为单位进行基金统筹,同时,有差别地在贫困农村实施以"大病统筹为主,兼顾特殊人群门诊利用"的制度设计模式。Objective To compare urban and rural residents＇ health service demand so as to explore the designing model of new rural cooperative medical system（NRCMS）. Methods Pilot urban and rural areas of NRCMS in Taiyuan （Yingze district, Wangbailin district,Xinghualing district, Jiancaoping district and Loufan county） were chosen for survey of household health service. Data of farmers ＇ demand for health service were collected and characteristics of health service demands were compared between urban and rural residents. Results There was a significant difference in sociodemographic factors for different social economic environments in which urban and rural residents live. There were significant differences in health service demands between urban and rural residents. Contrast to the urban areas, farmer bi--week disease prevalence rate was higher in Loufan county,and chronic disease prevalence rate is so as that too（P〈0. 001）. The days of bi-week disease sufferer in bed are 16.75 times more than those in city（P〈0. 001）. ConclusionsThe lower the social economic development level, the higher the residents＇ health service demand, the lower the ability to collect funds. Therefore,NRCMS should be planned as a whole especially for fund collection. The designing model of overall consideration of medical service for catastrophic diseases and outpatient service for special population should be adopted.

关 键 词：卫生服务需要 新型农村合作医疗 模式 

分 类 号：R197.1[医药卫生—卫生事业管理]