农村居民个人年度医疗费用特征分析

Analysis on the Characteristic of Annual Individual Medical Expenditure for Rural Residents

目的:探索农村居民年度医疗费用特点及在不同特征人群中的分布。方法:用Excel函数处理麻城市2014年新型农村合作医疗门诊和住院数据库,整理出个人年度医疗服务利用信息。采用洛伦兹曲线和基尼系数描述农村居民医疗费用的聚集性,并用描述性统计方法分析农村居民费用特点及分布情况,卡方检验比较费用在人群中分布的差异。结果:在总人群中占比前5%的高医疗费用人群耗用了68%医疗总费用,高费用人群人均年总费用为16 628元,低费用人群为108元;农村居民医疗费用的基尼系数为0.81;女性和45岁以上人群的高费用比例大于5%;乡镇卫生院服务能力较弱地区、平原地区及靠近省道地区的居民中高医疗费用人群比例较高,分别为6.40%,5.50%和5.80%。结论:农村居民医疗费用具有明显聚集性;不同费用等级人群间费用差别较大;老年人口、女性和基层薄弱地区居民更容易产生高医疗费用。

Objective： To figure out the characteristics of annual medical expenditure fnr rural residents and its distribution among different population. Methods： The individual annual medical service utilization information was summarized after dealing with the database of the 2014 new rural cooperative medical system by Excel. It prescribed the clustering of medical expenditure by Lorenz curve and Gini index. Descriptive statistics and χ^2 test were used to compare the characteristics and distribution of the annual medical expenditure among rural residents. The Chi-square test was conducted to compare the differences of the population distribution. Results： The costliest 5% patients accounted for approximately 68% of total health care expenditure. The annual total expenditure was 16 628 yuan per capita among high-cost population, while low-cost population were 108 yuan. The Gini index of medical expenditure for rural residents was 0.81. Among female and population over 45 years oht, the proportion of high-cost population was higher than 5%. People living near provincial road, in flatlands or areas where the ability of township hospital was limited were more likely to expense higher medical costs, known as 6.40%, 5.50% and 5.80% separately. Conclusion： Clustering of medical expenditure for rural residents was remarkable, while the expenditure among high-cost, medium-cost and low-cost population were quite different. The chiefly, female and primary population living in areas where the ability of township hospitals were limited were more likely to generate high medical costs.