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目的了解新农合门诊统筹基金支付方式改革后宁夏盐池县农村居民的住院情况及影响因素。方法采用多阶段分层整群机械抽样方法,按照社会经济状况从宁夏盐池县下辖的8个乡镇100个行政村中按比例抽取40个行政村,共抽取1 320户进行问卷随访调查。结果 2011年宁夏盐池县农村居民的住院率为7.4%(374/5 031),低于2009年基线调查时的7.9%(425/5 358);农村居民对住院机构的选择主要是县级医院,占60.2%,基线调查时占50.8%(χ2=11.699,P<0.01);疾病未愈因经济困难自己要求出院者占58.7%,基线调查时占62.4%(χ2=8.925,P<0.05);多因素分析显示,女性、年龄较大、患有慢性疾病者是住院率增高的主要因素。结论住院率基本控制,试点研究初见成效,还需加强对乡镇卫生院的投入,提高其住院服务能力,改善农民的住院流向;女性、老年人、患有慢性病者是影响住院率增高的重点人群。
Objective To understand the hospitalization status of rural residents in Yanchi County, Ningxia Hui Autonomous Region and its influencing factors after the reform of the new rural cooperative medical fund co-ordinating fund payment. Methods A multi-stage stratified cluster mechanical sampling method was adopted. According to the socioeconomic conditions, 40 administrative villages were selected proportionally from 100 administrative villages in 8 towns and villages under the jurisdiction of Yanchi County in Ningxia. A total of 1 320 households were sampled for follow-up survey. Results The hospitalization rate of rural residents in Yanchi County in Ningxia in 2011 was 7.4% (374/5 031), lower than the baseline survey of 7.9% (425/5 358) in 2009; rural residents’ choice of hospital institutions was mainly county-level hospitals , Accounting for 60.2% and 50.8% at the baseline survey (χ2 = 11.699, P <0.01); 58.7% of them were discharged due to financial difficulties due to financial difficulties, 62.4% of baseline survey (χ2 = 8.925, Multivariate analysis showed that women, older adults with chronic diseases, were the major factors in the increase of hospitalization rate. Conclusion The basic control of hospitalization rate and pilot study have achieved initial success. It is also necessary to strengthen the investment in township hospitals, improve their hospital service capacity and improve their hospitalization flow. Women, the elderly and those with chronic diseases are the key factors influencing the increase of hospitalization rate crowd.