抚州市不同收入水平城镇居民卫生服务公平性分析

Analysis for health service equity in the different income levels of urban residents in Fuzhou City

目的分析抚州市不同收入水平城镇居民卫生服务公平性。方法选择抚州市不同收入水平人群,共3486户13048名,对不同收入水平人群卫生服务需求情况、门诊服务利用情况、住院服务利用情况、住院费用支付情况进行分析。结果不同收入水平人群2周患病率差异具有统计学意义（χ^2=21.615,P〈0.05）,各组慢性病患病率未见显著性差异（χ^2=9.615,P〉0.05）,2周患病就诊率差异具有统计学意义（χ^2=19.357,P〈0.05）,各组2周患病治疗比例有显著性差异（χ^2=20.871,P〈0.05）。随收入水平升高,年人均住院天数、年住院率差异具有统计学意义（χ^2=18.173,23.982,P〈0.05）,各组因经济困难未住院比例显著性下降（χ^2=25.139,P〈0.05）。各组住院费用并未呈现出显著性差异（χ^2=12.094,P〉0.05）,自付住院费用占人均收入比例、自付住院费用占家庭收入比例显著下降,差异具有统计学意义（χ^2=31.572,29.148,P〈0.05）。结论抚州市不同城镇居民卫生服务存在一定程度的差异性,应加强对低收入人群的政策倾斜,保证医疗卫生服务的公平性。

Objective To analyse the health service equity in different income levels of urban residents of Fuzhou city. Methods Different income levels of citizens from fuzhou city were choosen, there was a total of 3 486 households, 13 048 people, health service demand of different income levels, the outpatient service utilization, the length of service utilization, hospitalization fee payments were analyzed. Results Two week prevalence showed a downward trend, the difference was statistically significant （Х^2 =21. 615, P〈0.05）, the chronic diseases prevalence did not show significant difference （Х^2= 9. 615, P〈 0.05）. two week outpatient rate was differences statistically significant （ Х^2 = 19. 357, P〈0.05）, 2 weeks ill treatment ratio had significant difference （ Х^2 = 20. 871, P〈0.05）. With income levels rise, the annual average per capita hospitalization days of hospitalization showed statistically significantdifference （Х^2= 18. 173, 23. 982, P〈0. 05）, significant declines in the proportion between groups due to financial difficulties not hospitalized （Х^2 = 25. 139, P〈0.05）. Group hospitalization costs did not show significant difference （Х^2= 12. 094,P〈0.05）, the proportion of out-of-pocket medical expenses account for per capitaincome, out-of-pocket medical expenses account for a significant reduction in the proportion of household income showed statistically significant difference （ Х^2 = 31. 572, 29. 148, P〈0.05）. Conclusion different urban residents health services of Fuzhou city exist a certain degree of unfairness, which should strengthen the policy tilt of low-income people to ensure the fairness of medical and health services.