参合农民三级医院就医负担分析及启示——以四川省中江县为例

Analysis and Implication on the Medical Burden of Farmer in Tertiary Hospital:A Case Study of Zhongjiang County of Sichuan Province

以在三级医院住院的参合农民为研究对象,重点考察住院补偿与疾病经济负担,为制定卫生政策提供参考。以住院天数、患者年龄、自付费用为分组指标,通过组间比较分析发现,参合农民在三级医院住院,新农合补偿水平低,农民就医负担重,新农合和大病保险制度不同程度地降低灾难性卫生支出发生率,中年群体健康风险比较严重,老年群体疾病负担比较重。基于风险管理理论,将农民工纳入公共卫生服务,加强健康教育降低疾病发生率;新农合和医疗救助等保障政策向老年人倾斜,将年龄纳入补偿政策,防止老年贫困。

The farmers who had enrolled in the new rural cooperation medical system were investigated to analyze the disease burden and the hospital compensation in tertiary hospital, which was aiming to give suggestions to promote and optimize health policy. The comparison between groups were made with the indicators including hospitalization days, patient age and hospitalization expenses. The results showed that the effective reimbursement proportion was low and the farmer still had heavy burden of disease in tertiary hospital. The new rural cooperation medical system and the critical illness insurance program respectively reduced catastrophic health expenditure in different degrees. The health risks of middle-aged population were more serious. Elderly population faced the heavy burden of disease. Based on risk theory, some suggestions were made, which included covering migrant workers into public health service system, strengthening health education to reduce the morbidity, incorporating age into compensation policy and paying more attention to prevent the elderly poverty.