基于三期面板数据对宁夏盐池县农村育龄期妇女卫生服务利用公平性的研究

Research on the equity of health service utilization for women of childbearing age in rural Ningxia based on three-phase panel data

目的了解宁夏盐池县农村育龄期妇女服务卫生服务利用情况,并探究其影响因素,为后续医疗卫生体制改革提供参考依据。方法选取“农村居民家庭健康询问调查”2009年基线数据,以及后续2015年和2019年的随访数据,使用集中指数分析育龄期妇女卫生服务利用的公平性,使用集中指数分解法分析育龄期妇女卫生服务利用不公平贡献的影响因素。结果3次调查两周就诊率的集中指数分别为0.0131,0.0828,0.0049;3次调查住院率的集中指数分别为0.0286,0.0709,0.0702。集中指数分解显示,年龄、家庭人口数、自评健康状况、慢性病患病情况是门诊服务利用不公平贡献的主要影响因素;婚姻状况、家庭年人均收入、自评健康状况和慢性病患病情况是住院服务利用不公平贡献的主要影响因素。结论宁夏盐池县农村育龄期妇女卫生服务利用水平较低,门诊和住院公平性受各方面因素的影响。卫生行政部门可加大对门诊和住院服务的补偿力度,完善医疗卫生服务体系,重点关注农村育龄期妇女健康。

Objective To understand the utilization of health services for women of childbearing age in rural Ningxia,and to explore its influencing factors,so as to provide reference for the follow-up medical and health system reform.Methods The baseline data of 2009 in the"Rural Household Health Inquiry Survey"and the follow-up data in 2015 and 2019 were selected to analyze the fairness of health service utilization for women of childbearing age using the concentration index,and the influencing factors of unfair contribution of health service utilization for women of childbearing age using the concentration index decomposition method.Results The concentration index of two-week consultation rate in three surveys was 0.0131,0.0828 and 0.0049,respectively.The concentration indexes of hospitalization rates in the three surveys were 0.0286,0.0709 and 0.0702,respectively.Centralized index decomposition shows that age,toilet type,family size,self-rated health status and chronic diseases are the main influencing factors of unfair contribution of outpatient service utilization.Marital status,family annual per capita income,self-rated health status and chronic diseases were the main influencing factors of unfair contribution of inpatient service utilization.Conclusion The utilization level of health services for women of childbearing age in Yanchi county is lower,and the fairness of outpatient service and hospitalization is affected by various factors.The health administrative department should increase compensation for outpatient and inpatient services,improve the medical and health service system,and pay more attention to the health of rural women of childbearing age.