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[目的]调查贫困山区农民的医疗服务需要与利用情况,评价疾病负担程度,探讨导致家庭医疗费用上涨的主要因素。[方法]2007年10月,采用横断面研究方法,入户问卷调查分层随机抽取的泸水县246户1163名山区农民。[结果]山区农村1163名居民的两周患病率、两周就诊率、年住院率分别为21.9%、20.0%、11.7%,均高于2008年第四次国家卫生服务调查的全国农村水平(P﹤0.05)。246个山区家庭年支出医疗费用平均为700元,户主自评最近1年家庭疾病负担重的占48.4%。多重线性回归分析表明,导致家庭医疗费用上涨的主要因素是年住院人次、两周就诊人次。[结论]贫困山区健康需要量较高,“看病难”虽有缓解,“看病贵”仍然突出,应健全基层医疗卫生服务体系,促进基本公共卫生服务均等化,降低医疗费用,提高居民健康水平。
[Objective] To investigate the needs and utilization of medical services in poor mountainous areas, evaluate the burden of diseases and discuss the main factors leading to the increase of family medical expenses. [Method] In October 2007, a total of 1163 mountain farmers from 246 households in Lushui County were randomly selected by stratified study and questionnaire survey. [Results] The two-week prevalence and two-week visiting rate of 1163 inhabitants in mountainous rural areas were 21.9%, 20.0% and 11.7% respectively, both higher than the national rural level surveyed by the Fourth National Health Service Survey in 2008 (P <0.05). The average annual medical expenses of 246 mountainous families is 700 yuan, while the head of household accounts for 48.4% of the family disease burden in the recent one year. Multivariate linear regression analysis showed that the main factors that led to the rise of family medical expenses were the number of inpatient visits and the two-week visits. [Conclusion] Although there is a high demand for health in impoverished mountainous areas, although it is still difficult to see the disease, the medical treatment for the poor is still outstanding. The primary medical and health service system should be improved to promote the equalization of basic public health services, reduce the medical expenses, Improve the health of residents.