重庆潼南医保类型和重要心血管疾病调查研究

Investigation of the types of medical insurance and the key cardiovascular diseases among the resi- dents in Tongnan, Chongqing City

目的分析重庆市潼南农村地区居民医保类型和重要心血管病的调查数据，以期对医疗改革提供一定依据。方法选取“中国重要心血管病患病率调查及关键技术研究”在重庆潼南的调查数据（多阶段随机分层抽样的问卷调查），通过Excel2007软件录入数据，SPSS17．0统计软件处理数据并对数据进行一般描述性分析，了解当地居民的医保类型和重要心血管病情况。结果1035名居民中，男性534人，女性501人，总平均年龄（61．25±13．74）岁，享受新农合和商业医保的比例分别为93．91％和0．39％。患高血压、糖尿病及两者并存的共276人（占26．67％），其中261人（94．57％）在1年内未住院治疗．多在初级医疗机构就诊随访。仅有15人（5．43％）在1年以内因病住院，平均住院2．93次，平均每次住院6．53d；15人中有7人在初级医疗机构、5人在二级医院、3人在三级医院接受住院治疗：医保报销后，平均每人每次支付住院费用4362元。结论应在农村地区继续实施新农合政策，适当宣传并推广商业保险，落实分级诊疗和社区首诊制，适当调整医保报销比例和方式，加强全科医生的培养，建立医院帮扶和双向转诊制度。

Objective To provide possible evidences for the medical reform by analyzing the survey data of medical insurance and key cardiovascular diseases among rural residents in Tongnan, Chongqing City. Methods The survey data, collected in Tongnan, Chongqing from Chinese important cardiovascular disease prevalence survey and key technology research which was a multi-stage stratified random sampling questionnaire survey research, Was selected to discover the status of medical insurance, cardiovascular dis- eases and medical care among local residents through inputting the data by the Excel 2007 software and through generally descriptively analyzing the data by SPSS 17.0 statistical software. Results Of 1 035 resi- dents, male 534, female 501, total average age was （61.25 ± 13.74） years old, the coverage rate of new rural cooper-ative medical insurance was 93.91% and commercial medical insurance was 0.39%; the total morbidity rate of hypertension or diabetes and both was 26.67% （276 patients）. Within one year, 94.57% of the 276 patients were not hospitalized but were covered by the medical care and were followed up in the primary health institutions. And only the rest 15 ones （5.43%） were under hospitalization, among which 7 were in primary, 5 were in secondary and 3 were in tertiary medical care institutions; the average hospitalization frequency was 2.93 times in one year and 6.53 days for each time. The average hospitalization cost was 4 362 yuan each time for each patient after insurance reimbursement. Conclusion It was recommended to continue to implement the new rural cooperative medical insurance in rural areas, to promote the commer -cial medical insurance appropriately, to set up and carry out the hierarchical medical system and the first medical care in community, to adjust medical insurance reimbursement proportions and patterns, to strengthen the cultivation of general practitioners, to establish hospital supports and dual referral system.