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目的:通过基线调查与5次追踪调查的比较,评价新型农村合作医疗(简称新农合)的实施对农民医疗服务需求和利用的影响,并探索其变化规律,为进一步完善新农合实施方案提供科学依据。方法:采用多阶段分层整群随机抽样法抽取婺源县3个乡镇9个行政村,每村各取70户进行入户调查,将6次调查结果进行纵向对比研究。结果:本次调查两周患病率为73.28‰,较2007年有所下降但高于2005年和2006年的调查结果;两周就诊率为102.18‰,6年来呈先降后升的趋势;患者未就诊率为24.57%,较2007年有所下降;年住院率为84.59‰,6年来呈明显上升趋势;需住院未住院率为6.47%,6年来呈明显下降趋势;因经济困难未就诊的比例本次仅占9.30%,为历年最低,未就诊主要原因本次调查为自我医疗,占34.88%;因经济困难未住院的比例为81.82%,高于以往5次调查结果,提前出院的主要原因为经济困难,占66.70%。结论:新农合对农民门诊服务利用的影响不大,但促进了农民对住院服务的利用,经济困难仍是影响农民住院服务利用的主要原因,但已不再是影响农民门诊服务利用的主要原因。
OBJECTIVE: To evaluate the impact of the implementation of new rural cooperative medical services (NRCMS) on the demand and utilization of peasants’ medical services by exploring the baseline survey and the five follow-up surveys and to explore the changing rules. In order to further improve the implementation plan of NCMS, Provide a scientific basis. Methods: The multi-stage stratified cluster random sampling method was used to extract 9 administrative villages in 3 towns and villages in Wuyuan County. Each village took 70 households for household survey, and the results of 6 surveys were compared vertically. Results: The prevalence in the two-week survey was 73.28 ‰, which was lower than that in 2007 but higher than that in 2005 and 2006. The two-week visit rate was 102.18 ‰, which showed the trend of first decreasing and then increasing in six years. The rate of unaccounted for patients was 24.57%, down from 2007; the annual hospitalization rate was 84.59 ‰, showing an obvious upward trend in 6 years; the unaccounted for hospitalization rate was 6. 47%, showing a clear downward trend in 6 years; This is only 9.30%, which is the lowest in calendar year. The main reason for not visiting this survey is self-medication, accounting for 34.88%. Due to financial difficulties, the proportion of non-hospitalized patients was 81.82%, which was higher than the previous 5 findings and was discharged earlier Mainly due to financial difficulties, accounting for 66.70%. Conclusion: The NCMS has little effect on the outpatient service utilization of peasants, but it has promoted the utilization of hospital services by peasants. Economic difficulties are still the main reason that affects the utilization of peasants’ inpatient services, but it is no longer the main factor that affects the utilization of outpatient services the reason.