宁夏海原县新农合方案调整前后健康公平性比较

Comparison of Health Equity of New Rural Cooperative Medical Scheme after Policy Adjusting in Haiyuan County of Ningxia

目的:了解宁夏支付制度改革项目试点县(海原县)农村居民新农合支付制度改革后健康公平性的变化。方法:采用多阶段分层整群随机抽样法,入户调查。以经济收入作为分层变量,以自感健康状况、两周患病率、慢性病患病率、两周休工(学)率、两周卧床率为描述指标,集中指数(CI)和差别指数(DI)为分析性指标。结果:两次调查自感健康状况、两周患病率、慢性病患病率、两周休工(学)率、两周卧床率的差异均有统计学意义。各项指标的CI绝对值均小于0. 2,且2015年均低于2009年,DI值均接近0,且2015年均低于2009年。结论:新农合方案调整后试点县(海原县)农村居民健康公平性有所改善,但仍需通过政策调整等方式来提高低收取人群的医疗保健现状。

Objective Understanding the change of health equity for rural residents after reforming the new rural cooperative medical system in the Ningxia payment system reform project pilot county （ Haiyuan County）. Methods Using a multi - stage stratified cluster random sampling method to obtain the sample survey. We adopted the economic income as the objective variable stratification, using the perceived health status, two weeks prevalence, chronic the disease prevalence rate, two weeks off work （ study） rate, the rate of two weeks in bed as the descriptive indexes, selecting the Concentration Index （CI） and Difference Index （DI） as the analysis indexes. Results In the two surveys, there were significant differences about the perceived health status, the rate of two - week illness, the prevalence rate of chronic disease, the rate of two weeks off （school） and lying in bed for two weeks. The absolute values of the index CI were less than 0. 2, and the absolute values of 2015 were lower than 2009＇ s. The values of DI were close to zero, anti the values of 2015 lower than 2009＇ s. Conclusion There has been improved about the health equity for rural residents after reforming the new rural cooperative medical system in pilot county of Haiyuan, but it is necessary to improve the status of health care among the low - income people by adjusting some policy.