湖北省西部某市家庭灾难性卫生支出及影响因素分析  

Analysis on Family Catastrophic Health Expenditure and Influencing Factors in a City in the West of Hubei Province

作　　者：冯曾义[1] 李东华[2] 陈迎春 熊巨洋 王静 李萍 高红霞 冯占春 张翔 张治国[2] Feng Zengyi et al(Personnel Division, Wuhan Integrated TCM ＆ Western Medicine Hospital, Wuhan, 43002)

机构地区：[1]武汉市中西医结合医院人事处,武汉430000 [2]华中科技大学同济医学院医药卫生管理学院,武汉430030 [3]湖北省人文社科重点研究基地,农村健康服务研究中心,武汉430030

出　　处：《医学与社会》2017年第4期52-55,共4页Medicine and Society

基　　金：国家自然科学基金面上项目,编号为71273100;华中科技大学“中央高校基本科研业务费”,编号为2014WZ08

摘　　要：目的:了解湖北省西部某市家庭灾难性卫生支出发生情况,探究主要影响因素。方法:2014年和2015年,分别对3个乡镇进行入户调查,测算家庭灾难性卫生支出发生率、发生强度及集中指数;运用二项Logistics回归,分析灾难性卫生支出发生的主要影响因素。结果:2014年和2015年样本地区总体灾难性卫生支出发生率分别为23.68%和26.9%%,且差异没有统计学意义(P=0.186);不同经济水平家庭的灾难性卫生支出发生率和平均差距随着收入的提高呈下降趋势;家庭就业比例、住院次数、家庭老年人比例、家庭收入水平是家庭灾难性卫生支出发生的主要影响因素。结论:调研地区的灾难性卫生支出发生状况有待改善,应提高居民收入、加强人群尤其是老年人群的疾病预防控制、提高居民住院的实际补偿比例、加大对贫困和发生高额医疗费用家庭的补偿和补助力度,降低灾难性卫生支出。Objective： To assess the occurrence of family catastrophic health expenditure （CHE） in a city in the West of Hubei Province and final out the determinants. Methods： Carrying out the household investigation of three towns in the district in 2014 and 2015 respectively to calculate the incidence, intensity and concentration index of family CHE. Using binary logistic regression to identify the determinants of CHE. Results： The overall incidences of CHE in 2014 and 2015 were 23.68% and 26.9% respectively, and the difference was not statistically significant（P= 0.186）. The incidence of CHE and the average gap between different income level families decreased with the increase of income. Employment ratio, number of hospitalized patients, ratio of elderly in the family, and level of family income appeared to be the main determinants of CHE. Conclusion： The CHE in the region needs to be improved. We should increase the income of residents, strengthen disease prevention and control especially in the elderly popula- tion, improve the actual compensation ratio of hospitalization, increase compensation and subsidies of the families with poverty and high medical costs and other measures, so as to reduce the occurrence of CHE.

关 键 词：灾难性卫生支出 因病致贫 支付能力 

分 类 号：R19-0[医药卫生—卫生事业管理]