湖北省农村地区住院服务利用的家庭聚集性分析

Analysis of Family Clustering of Inpatient Service Utilization in Rural Areas of Hubei Province

目的了解湖北省农村地区住院服务利用的家庭聚集性大小及其分布。方法以湖北省麻城市2014年新农合住院数据库为基础,利用Excel 2010中的"IF""LOOKUP"等函数获取样本县区所有农村家庭的住院利用情况;利用面积图和散点图绘出洛伦兹曲线并计算出基尼系数;采用IBM SPSS Statistic 22.0对数据进行描述性统计和方差分析等。结果 3%的家庭利用了19%的住院服务,农村家庭住院服务利用的基尼系数为0.366;高住院服务利用家庭门诊服务利用量(29.2±26.9)低于中等住院服务利用家庭(3 1.7±23.5);除低住院服务利用个体外,高住院服务利用家庭中住院服务利用成员的住院量都大于其他家庭(N_(高高)9.2>N_(中高)4,N_(高中)2.4>N_(中中)2.2>N_(低中)1.7);高住院服务利用家庭到县医院的驾车时间最短(t_高44.3<t_中44.9<t_低45.2),家庭住院人数最多(N_中4.5>N_高4.4>N_低3.9)。结论农村地区住院服务利用存在较大的家庭聚集性,存在一定不合理性:门诊服务利用的提高可能会降低住院服务的利用。

Objective To analyze family clustering of inpatient service utilization in rural areas of Hubei Province. Method Inpatient service information of all families in rural areas of sample counties was obtained on the basis of New Cooperative Medical System （NCMS） inpatient database; Lorentz curve was drawn by area graph and scatter diagram of Excel 2010, so was Gini coefficient; descriptive statistic, variance analysis and so on were carried by IBM SPSS Statistic 20.0. Result 3% family takes up 19% inpatient service, and rural family’s Gini coefficient of inpatient service utilization is 0.366; high inpatient service utilization family（HIUF） uses less outpatient service（29.2±26.9） than middle inpatient service utilization family（31.7±23.5）. Inpatient member of HIUF used more inpatient service than other families, except the low inpatient service utilization member（NHH9.2〉NMH4, NHM2.4〉NMM2.2〉NLM1.7）; HIUF use least time to reach county hospital（tH44.3〈tM44.9〈tL45.2）, have more inpatient members than others （NM〉4.5〉NH4.4〉NL3.9）. Conclusion Great family clustering of inpatient service utilization exists in rural area, and irrationality exists in some way; more outpatient service utilization may reduce inpatient service utilization.