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目的:了解城乡居民医疗负担变化趋势及其影响因素,探讨减轻我国医疗负担过重的途径。方法:提取《中国国家统计年鉴》全国31个省级行政单位1998—2010年的相关数据,采用多元回归模型和决策树模型探索我国城乡居民医疗负担的影响因素及机制。结果:近年来我国居民医疗负担呈现城镇居民逐渐减轻、农村居民逐渐加重的趋势;影响居民医疗负担的主要因素包括人口老化、医疗服务价格水平、居民收入水平等。树状图分析显示决定城镇医疗负担系数的有两级结构,决定农村医疗负担系数的只有一级结构。结论:近年来医疗负担过重主要来源于农村,应采取增加农村居民收入、加大农村医疗保障力度等措施。加大政府投入,提高对经济困难人群的医疗补助,减轻医疗负担。
Objective: To understand the changing trend of urban and rural residents’ medical burden and its influencing factors, and to explore ways to reduce the burden of medical care in our country. Methods: The data of 31 national administrative units in China from 1998 to 2010 were extracted from China National Statistical Yearbook, and the influencing factors and mechanisms of medical burden of urban and rural residents in our country were explored by multiple regression model and decision tree model. Results: In recent years, the burden on medical care of residents in our country has been gradually reduced and the rural residents have been gradually aggravated. The main factors influencing the medical burden on residents include population aging, medical service price and residents’ income. Dendrogram analysis shows that there is a two-level structure that determines the medical burden factor for urban areas and only one-level structure that determines the rural medical burden factor. Conclusion: In recent years, the overburdened medical care mainly comes from rural areas. Measures should be taken to increase the income of rural residents and increase rural medical security. Increase government investment to raise the medical subsidies for the economically disadvantaged groups and reduce the medical burden.