北京市亚运村社区居民医疗卫生服务利用变化情况

Analyses on the change of medical care and health services utilization of Yayuncun community residents in Beijing

目的 了解北京市亚运村社区居民医疗卫生服务利用的变化情况.方法 采用前瞻性研究,使用自行设计的〈北京市典型社区居民调查表〉,了解居民的就诊情况、医疗费用的支出及居民对医疗机构的满意度等情况.2004年和2005年对亚运村社区居民进行基线调查,2006年至2008年采用统一问卷进行随访调查,最终获得有效样本1412人.结果 调查前1个月中有病未就诊居民的比例逐年下降,2006年至2008年3年间差异有统计学意义（x2=22.35,P＜0.01）;居民不就诊的前3位原因分别为医疗费用太高、自感病情轻、自我用药.3年里居民到社区卫生服务机构就诊的人数逐年增加,差异有统计学意义（x2=50.85,P＜0.01）;支出的药费（x2=35.73,P＜0.01）、治疗费（x2=39.75,P＜0.01）、检查费（x2=12.98,P＜0.01）均逐年降低,差异有统计学意义;居民对常去医疗机构的满意度3年里逐年提高.结论 在北京市社区卫生服务工作的全面推进下,社区居民的医疗卫生服务利用度和满意度均有一定程度的提高.

Objective To know the change of medical care and health services utilization of Yayuncun community residents in Beijing. Methods Using the prospective study, residents above 15 years old were selected to answer the Beijing Typical Community Resident Questionnaire designed by the local researchers. In 2004 and 2005, the baseline survey was carried. From 2006 to 2008, same questionnaire was used to follow-up survey, and 1412 residents were selected into the last study. Results The proportion of people who should see a doctor but not in past month were decreased, the differences among the three years were significant （P 〈 0. 01 ）; The top three reasons that who should see a doctor but not were the ＂medical care costs too high＂, ＂self- felt the sickness light＂, ＂self-treatment＂. The residents who went to the community health agencies increased from 2006 to 2008. The medical costs （ drugs, medical fees,inspection fees） decreased from 2006 to 2008, the differences were significant （P 〈0. 01 ） ;The satisfaction increased from 2006 to 2008, the differences were significant （ P 〈 0. 01 ）. Conclusion Under the comprehensive promotion of community health services in Beijing, the satisfaction and the utilization of medical care and health services were improved.