四川省某县城乡居民慢性病情况、就医现状与经济负担调查

Investigation of the status and economic burden of receiving medical treatments of urban and rural residents with chronic diseases in a county of Sichuan province

目的：了解四川省某县城乡居民慢性病情况、就医现状及经济负担情况，为卫生预防及卫生服务体系发展提供政策依据。方法采用自行设计的调查问卷表，对2013年7月随机抽取的1000名威远县城乡居民进行问卷调查，并对结果进行统计学分析。结果95.2%的居民均患不同程度的慢性病，多数是农村高于城市；高血压患病率为48.1%，明显高于全国平均水平；慢性病患者对所患疾病的了解程度均很低。城市患者多在市级医院就医，相对更看重高诊疗水平，农村患者多在私人诊所就医，相对更看重低就诊费；明知患病却不就医的情况仍普遍，即使就医仍有超过80.0%患者没有完全按照医嘱执行。51.6%的城市患者和51.8%的农村患者家庭每月人均收入为＆gt;500~2000元；70.0%的城市患者和68.0%的农村患者均认为医疗总费用勉强可以接受，其中门诊挂号费排在易接受的首位，住院药品费排在难以接受的首位；64.3%的患者未参加医疗保险，且有19.9%的城市患者和9.1%的农村患者仍然认为医疗保险报销完全不能解决看病贵问题。结论城乡居民的基本健康状况不容乐观，慢性病患者的健康素养普遍较低，并面临很重的经济负担，农村情况较城市严重。提高居民健康素养，加强医疗机构建设与管理，稳步健康发展西部地区经济，改革和完善医疗保障制度，对改善现状可能是行之有效的方法。

Objective To investigate the present situation and economic burden of receiving medical treatments of urban and rural residents with chronic diseases in a county of Sichuan province and provide policy basis for the development of health prevention and service system. Methods The self-designed questionnaire were adopted to 1 000 urban and rural residents from Weiyuan county,who were randomly selected in June 2013,and the results were analyzed statistically. Results 95.2%residents were suffering from chronic diseases in varying degree,and the rural was higher than the urban;nearly 48.1%residents suffered from hypertension,which was obvious higher than the national average level;the patients with chronic disease knew little about their disease. The urban patients preferred to municipal hospital,which provided better medical treatments;while the rural pa-tients preferred to private clinic,which provided cheaper medical treatments;it was not unusual that the patients did not see the doctor knowing they were sick,and over 80.0%the patients,who saw the doctor when sick,did not respect the prescription com-pletely. The family monthly per capita income of 51.6%urban patients and 51.8%rural patients were between 500 and 2 000 RMB. Medical costs could be accepted grudgingly by 70.0%urban patients and 68.0%rural patients ,registration fee for outpa-tient service was the most easy to accept and drug fee for inpatient service was the most hard to accept. More than 64.3%patients did not attend medical insurance,and 19.9%urban patients and 9.1%rural patients still did not think that medical insurance re-imbursement could solve the problem of expensive medical treatments. Conclusion The basic health status of urban and rural residents are not good,the patients with chronic diseases have low healthy literacy generally and heavy economic burden,and the rural patients are more serious than the urban residents. It might be helpful to increase the health literacy of residents ,strengthen the construction of medical institutions and management,develop green economy of west area with steady steps,reform and im-prove the medical security system.