会泽县卫生服务利用的公平性研究

Analysis of Equity on Health Care Utilization in Huize County

目的了解会泽县新型农村合作医疗实施中,参合农民卫生服务利用的公平性,为制订合理的补偿方案提供依据。方法采用分层抽样的方法抽取2个乡镇,共调查农户1209户,计4646人。结果调查农民2周患病率为7.1%,2周患病就诊率为8.7%,均低于第三次全国卫生服务调查农村平均水平。2005年住院率为5.6%,高于全国平均水平(3.4%),不同乡镇和不同家庭经济收入农民门诊服务利用的差异不大,但住院服务存在统计学差异。住院率随收入增加而增高,需住院未住院比例随收入增加而降低。住院机构、次均住院费用和次均住院补偿费用在2个乡镇间有较大差异,而在不同经济收入间无明显差异。结论新型农村合作医疗实施中,应该注意提高卫生服务利用的公平性。

OBJECTIVE To investigate the equity of health care services utilization among peasants in Huize County which is the pilot county of the new rural cooperative medical system （CMS） in Yunnan Province, in order to explore the way of improvement of equity on health care services utilization. METHODS Stratified cluster sampling technique was used to select sample.The sample size was 1 209 peasant＇s households, and totally 4 646 persons. RESULTS The two weeks prevalent rate is 7.1%, and is much lower than national-wide rural average level in 2003. The health-seeking rate for illness in two weeks is 8.7%, and is also lower than national-wide rural average level. The rate to be in hospital in last year is 5.6%, higher than national wide horizontal 3.4%.The usages of out patients services between two studied townships and among peasants in different income groups had no significance.And the hospitalizations in these two townships and three groups had significant differences.The rate of hospitalization increased with income increase, and the percentage of no hospitalizing in those diagnosed patients who need to behospitalization decreased with income increase.The type of hospitals peasants had been, total fee per time of hospitalization and the money from CMS per time of hospitalization was difference between two townships, and had no significant among three groups. CONCLUSION It should pay more attention about improving health care equity when making health policies of CMS.