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目的分析参加不同医保制度的高血压患者卫生服务利用差异。方法使用全国卫生服务调查中黑龙江省数据,采用一般描述性分析、χ~2检验、F检验进行数据分析。结果城镇职工参保患者两周患病率(21.89%)、年住院率(4.34%)、住院实际报销比(51.83%)最高;两周就诊率(16.73%)最低。城镇居民参保患者两周患病未就诊率最高为44.44%;住院实际报销比最低为33.73%。新农合参保患者两周就诊率最高为42.08%;两周患病率、两周患病未就诊率、年住院率最低,分别为12.18%、16.97%、3.00%。参加不同医保制度的高血压患者在性别、文化程度、收入情况、高血压患病率、两周患病天数,两周患病率、两周就诊率、人均住院费方面差异均有统计学意义(P<0.01)。结论医疗保障制度可影响参保患者的卫生服务需要和利用。通过提高医疗保险的覆盖率,逐步缩小不同医疗保障制度保障水平的差距,逐步完善基层卫生机构慢病门诊补偿制度等方式,不断促进高血压患者卫生服务利用的公平。
Objective To analyze the differences in the utilization of health services among hypertensive patients participating in different health insurance systems. Methods Using the data of Heilongjiang Province in the National Health Service Survey, the data were analyzed by general descriptive analysis, χ ~ 2 test and F test. Results The prevalence of insured patients in urban areas was 21.89%. The annual hospitalization rate was 4.34%. The actual hospital reimbursement ratio was the highest (51.83%). The two-week visit rate was the lowest (16.73%). Urban residents insured patients up to two weeks the prevalence of non-visiting rate was 44.44%; hospital reimbursement than the lowest was 33.73%. The highest rate of two-week visit was 42.08%. The two-week prevalence rate, two-week prevalence rate, and lowest hospitalization rate were 12.18%, 16.97% and 3.00% respectively. Hypertension patients who participated in different health insurance systems had statistically significant differences in terms of gender, educational level, income, prevalence of hypertension, days of two-week illness, prevalence of two weeks, two-week visit rates and per capita hospitalization expenses (P <0.01). Conclusion The medical insurance system can affect the health service needs and utilization of insured patients. By increasing the coverage of medical insurance, gradually narrowing the gap between the levels of protection of different medical insurance systems, and gradually improve the compensation system for chronic disease outpatient services at grass-roots level, and constantly promote the fair use of health services in patients with hypertension.