慢性病共病对城市贫困家庭医疗卫生支出的影响研究

Studying the Influence of Multimorbidity on Medical and Health Expenditure of Urban Poor Families

目的:评估慢性病共病对贫困家庭医疗卫生相关支出的影响。方法:采用自行设计的问卷,对2 300户获得最低生活保障的贫困家庭进行调查。使用秩和检验、线性回归、分位数回归等分析方法进行评估。结果:有慢性病共病成员家庭的人均慢性治疗支出较有患1种慢性病成员家庭增加了20.95%;在第10、第25、第50、第75、第90分位下,有慢性病共病成员家庭的人均医疗卫生支出较无慢性病成员家庭增加了32.68%、32.65%、30.70%、32.89%、32.72%,家庭医疗卫生支出占总支出比重分别增加了5.12%、7.97%、13.56%、18.94%、21.60%。结论:慢性病共病增加了贫困家庭慢性病治疗支出、医疗卫生支出;加大了家庭医疗卫生支出占总支出比重,挤占了家庭其他支出。因此,应进一步加大慢性病共病门诊保障力度、逐步建立起支出性医疗救助制度、加强贫困家庭慢性病共病的社区管理及贫困家庭的自我健康管理。

Objective:To evaluate influences of multimorbidity on health expenditure of urban poor families.Methods:A total of2 300 poor families were surveyed with a self-designed questionnaire.Kruskal-Wallis Test,Linear Regression and Quantile Regression were used to assess the impact.Results:The per capita expenditure on chronic treatment for households with members with chronic co-morbidities increased by 20.95% compared to households with members suffering from 1 chronic disease;at the 10th,25th,50th,75th and 90th percentiles,the per capita expenditure on health care for households with members with chronic co-morbidities increased by 32.68%,32.65%,30.70%,32.89% and 32.72% compared to households without members with chronic diseases,and household health expenditure as a proportion of total expenditure increased by 5.12%,7.97%,13.56%,18.94% and 21.60% respectively.Conclusion:The multimorbidity increases the chronic disease treatment expenditure and health expenditure of poor families.The proportion of family medical and health expenditure in total expenditure has been increased,and other household expenditures have been squeezed out.Therefore,efforts should be made to improve the outpatient security of multimorbidity,establish expenditure based medical assistance system,strength community management and self-management of multimorbidity.