楚雄州农村居民卫生资源可及性与家庭医疗费用支出的关系

Relationship between Health Sesoueces Access and Family Medical Expense of Rural Residents in Chuxiong Prefecture

目的调查农村居民的家庭医疗费用支出情况及卫生资源可及性,探讨导致家庭医疗费用支出过多的主要影响因素.方法采用分层整群随机抽样法对楚雄州3 659户15 309名的农村居民进行入户调查.结果楚雄州农村居民家庭年医疗费用支出均值为1 987.5元.65.1%的住户离最近的医疗机构在1 km之内,高于全国调查水平;70.6%的住户在10 min之内能到达最近的医疗机构,低于全国调查水平.多重线性回归分析显示家庭医疗费用支出过高的影响因素为到最近医院所需时间、到最近医院距离、2周就诊人次、2周患病未就诊人次、年住院人次.结论农村居民的卫生服务供给已基本满足需要,但利用率不高;"看病难"现象已得到较大改善,但"看病贵"问题仍是影响利用率的主要制约因素;需继续加强对农村居民的健康教育,提高卫生服务可及性,缩小不同区域间居民健康水平差异.

Objective To survey the family medical expense of rural residents and health resoueces access,to explore the main factors raising the family medical expense.Methods Stratified cluster random sampling method was used to investigate3659rural families with15309residents in Chuxiong prefecture.Results The median of family annual medical expense was RMB1987.5yuan.65.1%of households from the nearest hospital within1km,which was higher than the average level of FNHSS.70.6%of households from the nearest hospital within10minutes,which was lower than the national average level.A Muitiple Linear Regression Analysis indicated that the time and distance from home to the nearest hospital,the persons with two week prevalence without consultation rate,the persons with two week consultation rate and the persons with annual hospitalization rate were positively associated with the high the family medical expense.Conclusions Rural health services can basically meet the people's needs.Although the difficulty in getting health services is being ameliorated,the medical charge is still the main restricting factor of utilization rate.It is suggested that the health education should be strengthened in rural areas,the accessibility of health services be improved,and the residents’health differences among regions should be reduced.