门诊统筹后农村居民住院情况及影响因素分析

Hospitalization and its influencing factors among rural residents after out-patient service reform of new rural cooperation medical system

目的了解新农合门诊统筹基金支付方式改革后宁夏盐池县农村居民的住院情况及影响因素。方法采用多阶段分层整群机械抽样方法,按照社会经济状况从宁夏盐池县下辖的8个乡镇100个行政村中按比例抽取40个行政村,共抽取1 320户进行问卷随访调查。结果 2011年宁夏盐池县农村居民的住院率为7.4%(374/5 031),低于2009年基线调查时的7.9%(425/5 358);农村居民对住院机构的选择主要是县级医院,占60.2%,基线调查时占50.8%(χ2=11.699,P<0.01);疾病未愈因经济困难自己要求出院者占58.7%,基线调查时占62.4%(χ2=8.925,P<0.05);多因素分析显示,女性、年龄较大、患有慢性疾病者是住院率增高的主要因素。结论住院率基本控制,试点研究初见成效,还需加强对乡镇卫生院的投入,提高其住院服务能力,改善农民的住院流向;女性、老年人、患有慢性病者是影响住院率增高的重点人群。

Objective To study hospitalization and its influencing factors among rural residents in Yanchi of Ningxia after out-patient service reform of new rural cooperation medical system.Methods Using multi-stage stratified cluster sampling method,a questionnaire survey was conducted among 5 031 rural residents of 1 320 households in 40 administrative villages.Results The hospitalization rate in the residents was 7.4% in 2011,lower than that in 2009（7.9%）.The medical institutions for the hospitalizations were mainly county hospital（60.2%） in 2011,with a higher ratio than that（50.8%） in 2009（χ2=11.699,P0.01）.The proportion of hospitalized residents leaving the hospital earlier because of financial difficulties was 58.7% in 2011 and significantly lower than 62.4% in 2009（χ2=8.925,P0.05）.Univariate analyses showed that women,elders,people with chronic disease were main reasons contributing to the increase of hospitalization.Conclusion Hospitalization rate is under the control and the reform archieves primary effect.Women,elders,and people with chronic diseases are main groups contributing to the increasing of hospitalization.