高血压患者门诊就医行为及医保政策分析

Analysis on the Treatment Seeking Behavior and Medical Insurance Policy of Out-patients with Hypertension in Urban Community

目的:分析我国城市高血压患者门诊就医行为及城市居民基本医疗保险政策,为完善我国高血压慢病管理和相应医保政策提供政策建议。方法:采取结构式问卷法,调查北京东城区、南京秦淮区和杭州下城区1788名高血压患者,并从当地社保中心获取调查对象2008年医保资料。利用SPSS12.0对数据进行描述性分析和卡方检验。结果:高血压患者两周就诊率达29.08%;高血压疾病门诊以社区和三级医院为主,分别占58.8%和27.9%;患者对社区服务满意度为84.8%。不同城市和规范管理高血压患者门诊流向有统计学意义(<0.05)。结论:社区卫生服务中心已成为高血压患者门诊就医首选,慢病规范管理与医保政策对高血压患者就医分流起到一定作用。

Objective：To analyse the characteristics of out-patient treatment seeking behavior in hypertensive patients and the relationship with the medical insurance policy in China＇s urban community,provide effective advice for improvement of chronic disease management and the medical insurance policy.Methods：The data was collected by surveying 1,788 hypertensive patients and the related medical insurance data from local insurance management Centers.Quantitative data was used descriptive analysis and chi-square test with SPSS12.0.Results：The two weeks outpatient visit is 29.08%;The rates of out-patients selected community health service and tertiary hospitals are 58.8% and 27.9% respectively.Patient satisfaction of community service is 84.8% and different cities and standard management have significantly affect on the flow of out-patients with hypertension medical treatment t（ 0.05）.Conclusion：Community Health Center has become the first choice for patients with hypertension outpatient medical treatment,chronic diseases with current standard management and medical insurance policies have played a significant role in treatment seeking behavior.