新疆农村贫困人口医疗服务利用变化分析

Analysis on the changes in health services utilization of poor rural population in Xinjiang province

[目的]分析新疆农村贫困人口的医疗服务利用变化情况,为进一步完善针对农村贫困人口的医疗保险和医疗救助等提供依据。[方法]利用新疆2003年和2008年两次卫生服务调查资料,对农村贫困人口的卫生服务需要与利用、医疗费用变化进行分析。[结果]2008年与2003年相比,两周患病率由56.1‰上升到130.2‰,差异有统计学意义(P<0.05);两周就诊率由43.5‰下降至35.3‰,差异无统计学意义(P>0.05);年住院率由31.4‰提高到58.8‰(P<0.05);未住院率由51.0%减少到13.3%(P<0.05),经济困难是未利用住院服务的主要原因;次均就诊费用年增长率为8.9%,次均住院费用年增长率为6.2%。[结论]新农合一定程度地促进了新疆农村贫困人口对基层医疗机构卫生服务的利用,但利用水平仍低于全国农村水平;医疗费用不断增长,而新农合补偿水平有限。建议加强新农合与贫困医疗救助制度的有效衔接;加快发展新疆农村经济,有效实施农村扶贫政策,重点关注少数民族贫困人口。

Objective To analyze the changes in health services utilization of poor rural population in Xinjiang province so as to provide scientific basis for perfecting medical insurance and medical assistance for poor rural population. Methods Analyzed the changes in health service requirements, utilization and medical expenses of poor rural population by the data of health service survey in 2003 and 2008. Results The two-weeks morbidity increased from 56.1‰ to 130.2‰ （P〈 0.05 ）, there was statistics significance. Two-weeks doctor visit rate decreased from 43.5‰ to 35.3%0 （ P 〉 0.05 ）, there was no statistically significant. Annual hospitalization rate increased from 31.4‰ to 58.8‰ （P 〈 0.05 ） . Not hospitalization rate decreased from 51.0% to 13.3% （P 〈 0.05 ） . The main reason of people without being hospitalized was financial difficulties. The average medical expense per treatment growth rate was 8.9%, the average medical expenses per hospitalization growth rate was 6.2%. Conclusions The new rural cooperative medical system promotes to utilize health services of primary health care institutions in poor rural population, but the utilization level was lower than nation level. Medical expenses were growing, but the new rural cooperative compensation level was limited. So we should strengthen effective join between new rural cooperative and poor medical assistance system. Develop rural economy in Xinjiang province. Carry out the rural aid-to-the-poor policy, in particular, focus on the minority nationality poor rural population.