四川省农村低收入人口门诊费用现况及影响因素分析  

STUDY ON OUTPATIENT EXPENDITURE AND INFLUENCE FACTORS OF THE LOW-INCOME RURAL POPULATION IN SICHUAN PROVINCE

作　　者：罗云梅[1] 林燕[1] 张菊英[1] 吕宇[1] 应桂英[2] 甘华平[2] 谭玲[3] 

机构地区：[1]四川大学华西公共卫生学院卫生统计学教研室,成都610041 [2]四川省卫生信息中心 [3]四川省卫生厅

出　　处：《现代预防医学》2011年第14期2692-2694,2705,共4页Modern Preventive Medicine

基　　金：四川省卫生厅科研基金(080321)

摘　　要：[目的]了解四川省农村低收入人口门诊次均医疗费用现状,探讨农村低收入人口门诊次均医疗费用的影响因素。[方法]利用四川省第四次国家卫生服务调查西部扩点数据资料,了解农村低收入人口门诊次均医疗费用水平;应用多水平方差成分模型探讨低收入人口门诊次均医疗费用的影响因素。[结果]从2003～2008年5年间,农村低收入人口门诊次均直接费用上涨了91.2%;影响农村低收入人口门诊次均医疗费用的主要因素有年龄、自评健康状况、慢性病、卫生服务可及性和就医机构。[结论]应扩大新农合保险统筹向门诊和慢性病延伸;重视农村低收入老龄人群,完善农村养老保险制度;大力发展农村医疗卫生服务体系并完善分级诊疗和双向转诊制度,从而缓解农村低收入人口门诊费用上涨的问题。[Objective] To study the status of the low-income rural residents’ outpatient expenditure in Sichuan province,and to explore the influence factors related to it.[Methods]The study based on the data from the enlarged survey in west China of the Fourth National Health Service Survey in Sichuan province,and described the outpatient expenditure in low-income rural population;Multilevel variance components model was used to analyze the influence factors.[Results]During five years from 2003 to 2008,the outpatient direct expenditure increased by 91.2%;The main factors of the low-income rural residents’ outpatient expenditure included age,self evaluation health status,chronic diseases,the distance to the nearest medical institution and the rank of the health institution.[Conclusion]It is essential to expand the insurance co-ordinate extended to clinic and chronic disease and pay more attention to the old group;It’s also very important to improve the rural medical health care system,making sure that institution of grading treatment and two-way referral going well.So we can control the outpatient expenditure.

关 键 词：低收入人口 门诊费用 影响因素 多水平模型 

分 类 号：R127[医药卫生—环境卫生学]