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目的掌握新型农村合作医疗实施前后农民未住院率,未住院原因和出院原因的变化,分析农民因经济困难所致的未住院率及出院原因在新农合实施后的改变,为正确认识和科学调整新型农村合作医疗的实施方案提供依据。方法采用多阶段分层整群随机抽样的方法抽取样本,入户进行家庭健康调查。结果农民未住院率2003基线为51.51%,2005评价为25.80%,2005基线为44.39%;未住院原因中经济困难所占的比例为2003基线78.09%,2005评价56.15%,2005基线41.86%;未愈自动出院者占总出院者的比例分别为2003基线51.4%,2005评价32.9%,2005基线52.8%。结论农民未住院率无性别差异,但有年龄差别,新型农村合作医疗实施后农民未住院率显著降低,因经济困难所致的未住院率及未愈自动出院率亦有下降,表明新农合目前在减轻农民疾病经济负担,解决农民因贫致病和因病致贫问题上已取得一定成效,但仍需要不断完善。
Objective To understand the changes of unaccounted hospitalization rate, hospitalization unintentional reasons and discharge reasons before and after the implementation of new rural cooperative medical system, analyze the change of unaccounted hospitalization rate and discharge reason of farmers due to economic difficulties after the implementation of new rural cooperative medical system, Adjust the implementation of new rural cooperative medical programs provide the basis. Methods A multi-stage stratified cluster random sampling method was used to collect samples for home-based household health survey. Results The non-hospitalization rate of peasants was 51.51% in 2003, 25.80% in 2005 and 44.39% in 2005. The proportion of economic difficulties in non-hospitalization was 78.09% in 2003, 56.15% in 2005 and 41.86% in 2005; The rates of spontaneous discharges to total discharges were 51.4% in 2003, 32.9% in 2005 and 52.8% in 2005, respectively. Conclusion There is no gender difference in the non-hospitalization rate of peasants, but there are age differences. The non-hospitalization rate of peasants is significantly reduced after the implementation of new-type rural cooperative medical system. The unaccounted for hospitalization due to economic difficulties and the unplanned automatic discharge rate also decline. At present, some achievements have been made in alleviating the economic burden of peasants ’diseases and in solving peasants’ problems caused by poverty, poverty and poverty, but they still need continuous improvement.