农村慢性病患者就诊流向及费用——基于江苏省的干预研究  

Rural chronic disease patient treatment flow and cost based on intervention study in Jiangsu Province

作　　者：谷小丽[1,2] 钱东福 殷璇 陈城[3] GUUiao-li;QIAN Dong-fu;YIN Uuan;CHEN Cheng(School of Healthi Policy and Management, Nanjing Medical University,Nanjing Jiangsu 211166,China;Health-Related Catastrophic Social Risk Warning Collaborative Innovation Center, Nanjing Jiangsu 211166,China;School Basic Medicine,Nanjing Medical University,Nanjing Jiangsu 211166,China)

机构地区：[1]南京医科大学医政学院,江苏南京211166 [2]健康相关重大社会风险预警协同创新中心,江苏南京211166 [3]南京医科大学基础医学院,江苏南京211166

出　　处：《中国卫生政策研究》2017年第11期46-51,共6页Chinese Journal of Health Policy

基　　金：国家自然科学基金项目(71473130)

摘　　要：目的:通过干预研究,分析干预对江苏农村慢性病患者就诊的影响。方法:采用多阶段随机抽样的方法,在江苏省南京市高淳区、泰州市靖江市和淮安市淮阴区按照实施方案中的标准基线共调查4 261人,其中干预组2 116人,对照组2 145人,进行为期一年的干预,并对干预前后农村慢性病患者的就诊流向、就诊次数及就诊费用变化进行分析。结果:干预后农村慢性病患者选择基层医疗卫生机构就诊率有明显提高,达到了81.5%,与干预前差异不明显,与对照组差异具有统计学意义;干预后患者基层年平均就诊次数超过了10次,高于干预前及对照组,具有统计学意义;干预后农村慢性病患者就诊费用降低,且低于对照组,差异具有统计学意义,与干预前差异不明显。结论:经过一年干预,在基层医疗卫生机构就诊的慢性病患者比例提高,但是患者的治疗费用尚未达到很好的控制,仍然需要国家政策支持以进一步规范患者的就医行为。Objective： To analyze the situation of seeking medical treatment and assess the impact of intervention on rural chronic disease patients. A comprehensive intervention strategy was developed and implemented in rural area of Jiangsu province. Methods： According to the implementation plan,a random sampling method was adopted in Gaochun,Jingjiang and Huaiyin districts of Jingsu province to select a total of 4 261 people to be surveyed on the baseline,with 2116 people were in the intervened group and 2 145 in the controlled group,which was conducted for one year. The changes of flow tendency,times and expenses of seeking medical treatment before and after the intervention were analyzed. Results： After intervention,patients with chronic disease choosing primary health institutions for medical treatment has obviously improved,which was observed to be significant when compared with the controlled group. The average times of seeking medical treatment in primary health institutions is exceeding 10 times and which is significantly higher than before the intervention and the controlled group. After the intervention,patients＇ medical expenses reduced,which is significantly lower than that of the controlled group. Conclusions： Through one year of intervention,more and more patients with chronic diseases were choosing primary health institutions for medical treatment. But the medical expenses have not yet achieved good control. So the support of national policy to further standardize the patients＇ behavior of seeking medical treatment is still needed.

关 键 词：就诊流向 费用 慢性病 农村 

分 类 号：R197[医药卫生—卫生事业管理]