四川省凉山彝族自治州城乡居民两周患病率现状及医疗支出状况分析

Analysis on two-week prevalence and medical expenditure status among urban and rural residents in Liangshan Yi Autonomous Prefecture of Sichuan Province

目的了解四川省凉山彝族自治州(凉山州)城乡居民两周患病率现状和医疗费用支出情况,为当地政府制定医疗保障和卫生健康政策提供依据。方法2020年8—9月期间,采用分层整群随机抽样的方法获取调查对象,收集其两周患病率、居民家庭收入和医疗支出情况等数据,并对数据进行分析。结果共调查来自凉山州5个县市15~<70岁城乡居民共计1789名;凉山州城乡居民两周患病率为14.81%,会理县最高(21.84%),越西县最低(10.27%),差异有统计学意义(χ^(2)=21.68,P<0.05),男性两周患病率(17.74%)明显高于女性(12.41%)(χ^(2)=9.97,P<0.05),年龄比较差异有统计学意义(χ^(2)=19.21,P<0.05),随年龄增长,两周患病率增高;2020年凉山州15~<70岁城乡居民年人均医疗支出中位数(M)为390.00元,木里县最高(527.78元),其次为会理县和西昌市(均为464.29元),昭觉县最低(183.34元),地区和年龄差异均有统计学意义(H=43.13、17.14,均P<0.05);2020年凉山州15~<70岁城乡居民年人均自付医疗费用M为193.75元,地区、性别和年龄差异均有统计学意义(H=67.03、-2.25、17.75,均P<0.05);2020年凉山州15~<70岁城乡居民年人均医疗支出占收入的比例为18.43%;自付医疗费用占医疗支出总额的比例为51.59%。结论四川省凉山彝族自治州城乡居民两周患病率低于国内其他地区水平,自付医疗费用比例相对较高,当地政府在制定医疗保障和卫生健康政策中应当充分考虑青壮年医疗负担问题,尤其要重视男性群体的医疗负担。

Objective To understand the status of the two-week prevalence and medical expenditures among urban and rural residents in Liangshan Yi Autonomous Prefecture(Liangshan Prefecture)of Sichuan Province,provide a basis for the local government to formulate medical security and health policies.Methods From August to September 2020,a stratified cluster random sampling was used to obtain the survey objects,to collect the data of the two-week prevalence,household economic income and medical expenditure,and the data were analyzed.Results A total of 1789 urban and rural residents aged 15-<70 years old from five counties and cities in Liangshan Prefecture were surveyed.The two-week prevalence rate in urban and rural residents of Liangshan Prefecture was 14.81%,that in Huili County(21.84%)was the highest and in Yuexi County(10.27%)was the lowest,and the difference was statistically significant(χ^(2)=21.68,P<0.05).The two-week prevalence rate in males(17.74%)was significantly higher than that in females(12.41%),and the difference was statistically significant(χ^(2)=9.97,P<0.05).There was statistically significant difference between the age groups(χ^(2)=19.21,P<0.05),two-week prevalence increased with age.In 2020,the median annual per capita medical expenditure of urban and rural residents aged 15-<70 in Liangshan Prefecture is 390.00 yuan,with Muli County was the highest(527.78 yuan),followed by Huili County and Xichang City(both 464.29 yuan),Zhaojue County was the lowest(183.34 yuan),there are statistically significant differences in region and age(H=43.13,17.14,both P<0.05).In 2020,the annual per capita out-of-pocket medical expenses of urban and rural residents aged 15-<70 in Liangshan Prefecture The median was 193.75 yuan,and the regional,gender and age difference were all statistically significant(H=67.03,-2.25,17.75,all P<0.05).In 2020,the median annual per capita medical expenditure to income of urban and rural residents aged 15-<70 in Liangshan Prefecture was 18.43 percent.The proportion of out-of-pocket medical expenses to total medical expenditure was 51.59 percent.Conclusion The two-week prevalence rate of urban and rural residents in Liangshan Yi Autonomous Prefecture of Sichuan Province is lower than that of other regions in the country,the proportion of self-paid medical expenses is relatively high,and the local government should fully consider the medical burden of young and middle-aged people when formulating medical security and health policies,and pay special attention to the medical burden of the male population.