统筹城乡居民卫生服务利用公平性研究——基于宁夏石嘴山市的调查  

Research on the equity of health services utilization overall urban and rural residents——Based on the survey of Shizuishan City,Ningxia

作　　者：李相荣 汤榕 LI Xiang-rong;TANG Rong(Public Heahh and Management School of Ningxia Medical University,Yinchuan Ningxia 750004,China)

机构地区：[1]宁夏医科大学公共卫生与管理学院,宁夏银川750004

出　　处：《卫生软科学》2018年第9期16-19,共4页Soft Science of Health

基　　金：国家社会科学基金:城乡基本医疗保障一体化制度构架下不同人群的健康公平性研究(15BGL188)

摘　　要：[目的]探索统筹城乡居民卫生服务利用的现状及其公平性,为提高城乡医保居民卫生服务利用公平性提出政策参考依据。[方法]采用分层随机抽样方法,入户问卷调查18岁及以上居民。以两周就诊率、年住院率为反映卫生服务利用情况的指标,采用卡方检验、集中指数CI分析卫生服务利用的公平性。[结果]被调查的869名城乡医保居民的两周就诊率为19.45%,年住院率为11.05%,不同年龄、婚姻状况、受教育程度的两周就诊率、年住院率比较差异有统计学意义(P<0.05),不同年龄组中两周就诊率、年住院率及门诊费用指标的集中指数倾向于高龄人群,住院费用的集中指数倾向于低年龄组,不同经济收入分组下两周就诊率、年住院率及门诊费用指标的集中指数倾向于低收入人群,住院费用的集中指数倾向于高收入人群。[结论]城乡医保居民卫生服务利用情况在不同年龄、不同收入分层人群中均存在不公平。应多关注高龄人群、低收入组人群的卫生服务利用情况,进一步发展经济、完善统筹城乡居民基本医疗保险政策。Objective To explore the status quo and the equity of health services utilization overall urban and rural residents so as to provide policy reference for improving the equity of health service utilization for residents in urban and rural areas. Methods A stratified random sampling method was used to investigate residents aged 18 and above. It took two-week visit rate and annual hospitalization rate as the indicators that reflected health services utilization. The Chi-square test and Concentration Index were used to analyze the equity of health services utilization.Results Two-week visit rate of 869 urban and rural residents with medical insurance was 19. 45%, and annual hospitalization rate was11. 05%. There was statistical significant in two-week visit rate and annual hospitalization rate comparison of different ages,marital status,and education levels patients（ P 0. 05）. The concentration index of the two-week visit rate,annual hospitalization rate,and outpatient expense index in different age groups tended to be among the oldest,and the concentration index of hospitalization costs tended to be lower age group. The concentration index of two weeks visit rate,annual hospitalization rate and outpatient expense in different income groups tended to low-income group. The concentration index of hospitalization costs tended to high-income people. Conclusions It is unfair that health service utilization among urban and rural residents in different ages and income groups. It is recommended to pay more attention to the utilization of health services in the elderly and low-income groups,further develop the economy,improve basic medical insurance policy overall urban and rural residents.

关 键 词：两周就诊率 年住院率 卫生服务 公平性 城乡医保 

分 类 号：R197.1[医药卫生—卫生事业管理]