全民健康覆盖视野下江苏省卫生服务利用公平性研究

Studying on The Equity of Health Care Utilization in Jiangsu Province in View of Universal Health Coverage

目的:分析江苏省城乡地区门诊和住院服务利用分布状况。方法:利用家庭入户调查数据,测量与比较城乡地区门诊和住院服务实际利用、预期需要和标化利用的收入五分组分布和集中指数。结果:江苏省居民卫生服务预期需要呈贫富均衡或低收入人群具有更高的卫生服务需要,但卫生服务实际利用随收入提高而增加,标化后卫生服务利用的贫富差距进一步扩大。结论:江苏省卫生服务"低收入、高需要、低利用"的现象没有彻底改变,卫生服务利用程度受卫生服务需要的影响较小,受社会经济因素影响较大;医疗保险在达到人口覆盖的目标后,需要提高医保补偿力度,兼以提高卫生服务可及性和居民健康意识,促进卫生服务利用公平。

Objective To analyze the distribution of utilization of outpatient and inpatient care in urban and rural Jiangsu. Method The indices of actual, need - predicted and need - standardized utilization were employed to calculate the distribution and concentration index of health care utilization based on household survey. Results The need - predicted health care utilization from the lower - income group was similar to or greater than that of higher - income group. But the actual utilization was increased with income. There had greater differences of need - standardized health care utilization among people with different income. Conclu- sion The health care utilization was mainly influenced by socioeconomic factors. It is suggested that compensation on medical cost from medical insurances needs to be improved to promote the health care utilization.