新医改政策对医疗服务可及性的影响研究

The effect of new medical reform policy on medical service accessibility

目的:调查安徽省城乡居民对基本医疗卫生服务的利用情况,分析医疗服务可及性现状及其影响因素。方法:自行设计《城乡居民新医改政策绩效评价调查问卷》,采用便利抽样法,在安徽省多个市县选取城乡3 038位居民进行一对一入户调查。结果:我省基本医疗保障制度覆盖率达86.1%;居所与社区医院距离在5 km以内的居民占75%;看病平均候诊时间在30 min以内者占67.3%;86.4%的居民认为目前看病依然贵,但相较医改前有所下降,看病贵主要体现在药品价格(86.1%)和各项技术检查费用(86.7%)上;医疗卫生服务能力、服务质量、服务人员数量、便利性和居民对医疗费用的承担能力有所提高;而医疗费用和候诊时间均有所下降。结论:新医改以来我省初步实现了城乡居民医疗保险的全面覆盖,基层医疗服务水平较前提高,人民"看病贵、看病难"问题得以缓解,医疗服务可及性方面呈现积极发展的趋势。

Objective： To investigate the utilization of medical care service of residents in Anhui province,and analyze the accessibility of medical care service and its influencing factors. Methods： Three thousand and thirty-eight residents from different cities and counties in Anhui province were investigated using self-designed questionnaire ＂ The questionnaire on New Medical Reform Policy Performance from Urban and Rural Residents＇ Evalution＂ by convenience sampling. Results： The cover rate of the basic medical insurance system in our province was up to 86. 1%. The residents within 5 km distance the residence from community hospital accounted for 75%. The residents with average waiting time within half an hour accounted for 67. 5%. The 86. 4% of residents believed that the current medical treatment was still expensive,but it was decreased compared with before the health reform which mainly reflected in the drug price（ 86. 1%） and technical inspection fee（ 86. 7%）. The medical and health service capacity,quality,quantity,convenience and residents＇ affordability have been improved. The medical expense and waiting time were decreased. Conclusions： Since the new reform of medical care has been carried out,the medical care insurance comprehensively covers,the basic medical service level improves, ＂ the difficulty and high total cost of getting medical service＂ is partially resolved,and the accessibility of medical service presents a positive trend.