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该文通过对黑龙江省大庆市就“医改”的实施对不同就业人群的卫生服务需求利用所产生的影响进行分析 ,认为 (1 )“医改”的实施杜绝了职工将门诊看病转向挂床住院 ,使得大庆市“医改”实施后参保职工门诊就诊率比实施前增加较多 ;参保职工住院率明显降低 ;(2 )大庆市“医改”实施后 ,职工患病未住院率明显下降 ,同时 ,限制了以往的住院利用过度情况。“医改”实施后 ,经济困难仍然是影响参保职工有病未住院的一个主要原因。“医改”的实施只在一定程度上缓解了参保职工因经济原因而导致的提前出院 ;(3 )医疗费用的负担方式在患者就医时对卫生服务机构的选择起了重要作用 ,由原来的大中型医院较为集中而转向定点医院 ;(4 )影响参保职工卫生服务利用的因素均与参保职工的年龄 (高龄人口对住院的利用增加 ,离退休人员对服务的利用显著高于其他人群 )和现在享受的医保形式 (“参保人群”、“未参保人群”、“补充医疗保险人群”)有关 ,而目前的医保形式又与职工的单位性质、就业状况及“医改”前的医保形式有密切关系
This article analyzes the impact of the “healthcare reform” implementation on the health service demand of different employment groups in Daqing City, Heilongjiang Province, and concludes that (1) the implementation of “medical reform” eliminates the need for employees to turn their outpatient visits to hospital beds. After the implementation of “medical reform” in Daqing City, the attendance rate of insured workers in outpatient clinics increased more than before; the hospitalization rate of insured employees was significantly reduced; (2) After the implementation of “medical reform” in Daqing, the rate of non-hospitalization of employees was significantly decreased. , Limiting the past overuse of hospitalization. After the implementation of “medical reform”, economic difficulties are still one of the main factors that affect the inability of insured employees to stay in hospital. The implementation of the “medical reform” only relieved the insured employees from early discharge due to economic reasons; (3) The burden of medical expenses played an important role in the choice of the health service organization when the patient sought medical care. Large and medium-sized hospitals are more concentrated and turn to designated hospitals; (4) The factors affecting the utilization of health services of insured employees are both related to the age of the insured employees (the use of hospitalization by the elderly population is increasing, and the utilization of services by retirees is significantly higher than other people. ) is related to the form of medical insurance currently enjoyed (“insured population”, “uninsured population”, “supplemented medical insurance population”), and the current form of health insurance is related to the nature of the employee’s unit, employment status and “medical reform” before Medical insurance forms are closely related