农村医疗支出型贫困人群住院机构选择及其影响因素分析

Medical Institutions Selection and Its Influencing Factors of Inpatients in the Illness-caused Poverty Families in Rural

目的研究农村医疗支出型贫困人口住院机构选择及其影响因素,为制定相关救助政策提供依据。方法:采用分层随机抽样的方法,在四川米易县、江苏滨海县、河北邢台县对453户医疗支出型贫困家庭住院患者进行入户调查。结果调查人群就医趋高性明显,对住院机构的选择受疾病严重程度、医疗机构的技术水平、优势医疗资源的可及性、周边人群就医偏好、家庭经济水平、医疗费用及其支付方式等因素的影响。结论就医可及性提升将使人群潜在趋高就医需求得以释放,应在提升县域内医疗机构的服务水平基础上,建设人群有序就医及分级支付等配套制度,同时逐步扩大社会救助范畴,提升对农村医疗支出型贫困人群的保障水平和保障效果。

Objective To explore the medical institutions selection and its influencing factors of inpatients in the illness-caused poverty families in rural so as to provide evidence for developing relevant assistance policies.Methods By multi-stage stratified random sampling method,453 inpatients in the illness-caused poverty families were face-to-face interviewed in Miyi County of Sichuan Province,Binhai County of Jiangsu Province and Xingtai County of Hebei Province.Results Respondents were more likely to choose higher level hospitals.Their choices were influenced by the？ severity？ of？ disease,medical level of hospitals,accessibility of medical services,preferences of the surrounding crowds,family economic status,medical expenses and the way of payment. Conclusion People＇s potential demands on high level hospitals will be released by promoting the availability of medical services.Basing on the improvement of medical service of county area medical institutions,we should perfect supporting measures for orderly medical treatment and hierarchically mode of payment,and meanwhile,gradually expand the category of social assistance and enhance the medical insurance level and efficiency of medical insurance system for illness-caused poverty groups in rural.