老龄化背景下广西城镇职工参保人群卫生服务利用分析  

Analysis on Health Service Utilization Among the Insured Population of Urban Workers in Guangxi Under the Background of Aging

作　　者：刘哲敏 罗红叶 冯启明 赵歆妍 刘伟 黄永耀 罗萍[3] LIU Zhe-min;LUO Hong-ye;FENG Qi-ming;ZHAO Xin-yan;LIU Wei;HUANG Yong-yao;LUO ping(School of Information and Management,Guangxi Medical University,Nanning Guangxi 530021,China)

机构地区：[1]广西医科大学信息与管理学院,广西南宁530021 [2]广西医疗保险研究会,广西南宁530022 [3]广西医科大学附属口腔医院,广西南宁530021

出　　处：《卫生经济研究》2021年第5期45-48,54,共5页

基　　金：广西哲学社会科学规划办课题“公立医院医患关系现状分析及和谐医患关系的重构研究”(13DSH001)。

摘　　要：目的:分析2017—2019年广西城镇职工参保人群卫生服务利用情况,为完善城镇职工医保制度提供依据。方法:利用广西基本医疗保险年报数据,对在职职工和退休人员两类参保人群的卫生服务利用情况进行分析。结果:2017—2019年广西城镇职工参保人员普通门急诊从2392.72万人次增长到2640.97万人次,门诊大病从455.72万人次增长到510.59万人次,住院人数从102.95万人增长到160.55万人,平均住院日逐年缩短,50%以上参保人员选择二级及以上医院就诊。结论:老龄化背景下定点医院医疗资源过度利用,住院服务利用增加,应提高卫生服务的利用效率,提高门诊统筹支付比例,控制医保基金支出水平。Objective To analyze the health service utilization among the insured population of urban workers in Guangxi from 2017 to 2019,so as to provide basis for improving the medical insurance system of urban workers.Methods Based on the data of the annual report of basic medical insurance in Guangxi from 2017 to 2019,this paper analyzes the health services utilization among employed workers and retirees.Results From 2017 to 2019,the number of general outpatient and emergency services for insured urban emploeyees in Guangxi increased from 23.9272 million to 26.4097 million,the number of outpatients with serious diseases increased from 4.5572 million to 5.1059 million,and the number of inpatients increased from 1.0295 to 1.6055 million.The average hospital stay is shortened year by year,and more than 50%of the insured population choose secondary and above hospitals.Conclusion Under the background of aging,the medical resources of designated hospitals are overutilized,and the utilization of hospitalization services is increased.It is necessary to improve the utilization efficiency of health services increase the proportion of overall payments for outpatients and control the expenditure level of medical insurance funds.

关 键 词：城镇职工基本医疗保险 老龄化 卫生服务利用 广西 

分 类 号：R197.1[医药卫生—卫生事业管理]