天津市两家医院老年患者医疗保障及费用负担调查

Investigation on Medical Security and Medical Expenses Burden of the Aged Patients in Two Hospitals in Tianjin

目的:研究天津市老年患者医疗保障及医疗费用负担情况,探究老年患者医疗费用负担的关键影响因素及其传导路径,实现对老年患者医疗费用的控制。方法:采用偶遇抽样方法对在天津两家医院就诊的200名天津老年患者进行问卷调查,并对数据进行路径分析。结果:16人自费,53.7%的老年患者认为医疗费用负担较重;大部分老年患者(62.1%)对医保政策知晓程度低;三级医院是多数老年患者(59.0%)选择就诊的机构;医疗保险公平性欠佳;老年患者身体状况、药品费用对医疗费用的影响有统计学意义(均P<0.05)。结论:扩大老年人医疗保险覆盖面,提高医疗保险额度;加强医疗保险政策宣传;发挥社区医疗卫生服务供给职能;根据收入制定不同的医保政策;提高老年人的健康素质,控制药费比例。

Objective : To study the situation of medical security and medical expenses burden of the aged patients in Tianjin, identify key factors and conduction path influencing medical expenses burden of the aged patients in order to achieve effective control. Methods : 200 aged patients were accidental sampled from two hospitals in Tianjin and surveyed with questionnaire and the data was carried on the path analysis. Results: 16 aged (8.4% ) were at their own expense, 102 aged (53. 7% ) thought that medical expenses burden was heavier; 62. 1 % of the aged patients were with poor healthcare policy awareness, 59. 0% of the aged patients went to tertiary hospitals, the equity of medical insurance is poor; the impact of elderly patients, physical condition and drug costs on medical expenses was statistically significant ( both P <0. 05). Conclusion:We should expand the medical insurance coverage for the aged and improve medical insurance amount, strengthen medical insurance policy publicity, play the supply function of the medical health service, develop different medical insurance policies based on income, improve health quality of the aged, control the proportion of drug costs.