黑龙江省不同医保制度居民卫生服务利用比较  

Comparison of the residents' health service utilization under three medical insurance systems in Heilongjiang Province

作　　者：赵希彦[1] 郝艳华[1,2] 吴群红[1] 许伟岚[1] 韩晓楠[1] 房鑫[1] 康正[1,2] 胡曼[1] 于益[1] 宁宁[1,2] 

机构地区：[1]哈尔滨医科大学卫生管理学院社会医学教研室,黑龙江哈尔滨150081 [2]复旦大学/国民健康社会风险预警协同创新中心,上海200032

出　　处：《中国卫生资源》2016年第3期172-175,194,共5页Chinese Health Resources

基　　金：国家自然科学基金重点资助项目(71333003);国家自然科学基金资助项目(71573068)

摘　　要：目的：分析基本医保制度覆盖下居民卫生服务利用差异。方法：使用全国第五次卫生服务调查黑龙江数据库，利用一般描述性分析、χ2检验、F检验进行数据分析。结果：不同医保人群在性别、年龄、婚姻、文化程度、就业状况、两周患病率、慢性病患病率、两周就诊率、两周患病未就诊率、年住院率、应住院未住院率和住院费用等方面的差异有统计学意义（P〈0.05）。结论：不同医保制度的居民卫生服务利用存在明显差异，城镇居民医疗保险参保者的服务利用较差，经济负担更重。应当继续提高医保制度覆盖面和保障水平，同时兼顾公平，缩小医保制度间的保障差异，提高卫生服务利用水平和公平程度。Objective：To analyze the differences of residents’ health service needs and utilization under three different medical insurance systems. Methods：Data was collected from National Health Service Survey Database of Heilongjiang. The general descriptive analysis,chi-square test and F test methods were conducted. Results：Among different medical insurance systems,there was statistical difference in gender,age,marital status,educational attainment, employment status,two-week prevalence rate,prevalence rate of chronic diseases,two-week consultation rate,two-week prevalence rate of non-consultation,annual hospitalization rate,non-hospitalization rate and average hospitalization expenses（P〈0.05）. Conclusion：There is significant difference in residents’ health service utilization among different medical insurance systems. The enrollees covered by urban residents’ medical insurance had heavier and lower health service utilization. It is suggested that the relevant departments continue to improve the coverage,security level and equity of medical insurance system and decrease the system gap to enhance the level and equity of the residents’ health service utilization.

关 键 词：基本医疗保险制度 卫生服务需要 卫生服务利用 黑龙江省 

分 类 号：R197[医药卫生—卫生事业管理]