新型农村合作医疗对江西省农村地区住院服务利用的影响  

A Longitudinal Study of the Influence of NRCMS on the Utilization of In hospital Service in Rural Areas of Jiangxi Province

作　　者：邹娇娇 袁兆康[1] 郑辉烈[1] 张连军[1] 

机构地区：[1]南昌大学公共卫生学院卫生统计学教研室,南昌330006

出　　处：《中国医科大学学报》2014年第8期686-690,共5页Journal of China Medical University

基　　金：国家自然科学基金(70763007)

摘　　要：目的研究新型农村合作医疗(新农合)对江西省农村地区住院服务利用影响的纵向变化,从住院服务角度评价新农合的实施效果。方法采用多阶段分层随机抽样方法抽取研究对象,进行5次入户调查。利用住院率、提前出院率及应住院未住院率等指标分析住院服务利用的动态变化及新农合对其的影响。结果 5次调查结果显示住院率呈上升趋势;提前出院率与应住院未住院率呈下降趋势,3个指标线性趋势检验差异均有统计学意义(P<0.05)。Logistic回归分析结果提示:排除其他因素之后,调查年份对增加住院率、减少应住院未住院率有显著影响(P<0.01)。人均筹资金额与住院率呈正相关关系,人均筹资金额与应住院未住院率呈负相关关系(P<0.05)。提前出院和应住院未住院患者中因经济困难所占比例呈显著下降趋势(P<0.05)。结论新农合显著提高了住院服务利用率,但是仍有上升空间。经济因素仍为主要制约因素,但对农民看病的制约能力已大大减弱。Objective To study the longitudinal change of the utilization of in-hospital service in rural areas of Jiangxi province influenced by newtype rural cooperative medical system （NRCMS）,and evaluate the implementing effects of NRCMS by in-hospital service.Methods Multistage stratified random sampling method was adopted to collect research objects,and 5 times of household survey were performed.The dynamic change of the utilization of in-hospital service and the influence of NRCMS were analyzed according to the indicators such as the rate of hospitalization,early discharge and not in-hospital.Results According to the 5 times survey,a rising trend was found in the rate of hospitalization and a downtrend in the rate of early discharge and the rate of not in-hospital,the liner trend test of 3 indexes were statistically different （P ＜ 0.05）.The result of the logistic regression analysis showed that,after the exclusion of other factors,the investigation year was significantly affect the change of the rate of hospitalization and the rate of not in-hospital （P ＜ 0.01）.The rate of hospitalization was positively correlated with financing level,and the rate of not in-hospital was negatively correlated with financing level （P ＜ 0.05）.The proportion of financial difficulty for early discharge and not in-hospital were significantly declined （P ＜ 0.05）.Conclusion NRCMS has significantly improved the utilization of in-hospital service,but there is still room for growth.Financial difficulty is still the main restrictive factor,but the restriction ability had been greatly weakened.

关 键 词：住院服务 动态变化 影响因素 新型农村合作医疗 

分 类 号：R195.1[医药卫生—卫生统计学]