重庆市某县县级医疗机构住院患者卫生服务利用与需求调查

Investigation on health service requirement and utilization in a county medical organization of Chongqing

目的通过调查重庆市某县县级医疗机构住院者的基本情况、住院费用,了解重庆市农村地区人群卫生服务需求和利用现状及其主要影响因素,为农村卫生适宜技术推广示范研究提供依据。方法抽取县综合医院、县中医院和县妇幼保健院,问卷调查3所医院当日全部住院患者和采集1个月全部出院患者病历对卫生服务需求及利用情况的数据进行统计学分析。结果医院类别、患者性别、年龄、科别、床费、诊疗费、其他费用等因素对住院总费用有显著影响。由于较高的住院费用,影响农村地区人群对卫生服务利用的质和量。结论在农村,女性的卫生服务利用率低于男性。国家新政策实施后卫生服务利用率有所提高。年龄>45岁的居民是卫生服务的主要需求者。县级医疗机构的主要需求方仍然是农村居民。农村卫生适宜技术有必要及时推广。

Objective To understand the health level of people living in county and the situation between the requirement and utilization of health service for rural residents in Chongqing as well as the main influential factors by investigating the basic condition and hospitalization expenditure. Methods Three county hospitals were included in our study： county general hospital, Chinese traditional medicine hospital, and maternal care hospital. The hospitalized patients from the three hospitals were investigated on a certain day by questionaire and the data of discharged patients in a month were collected and analyzed by SAS8.0 software. Results Factors such as the hospital type, sex, age, the cost for sickbed, diagnosis and treatment fee and so on were significantly associated with the total cost for hospitalization. Expensive hospitalization fee harms the quantity and quality of health service required by rural residents. Conclusion The utilization rate of health service by female was lower than by male in rural area. The total utilization rate of health service has been improved since the new policy about rural health service was carried out. People over 45 years old are the main consumers of health service. Peasants are still main consumers to medical organization at county level. Suitable technic of health service for county hospitals should be carried out in time.