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目的了解浙江省农村老年人的卫生服务利用状况及医疗费用负担,为相关措施制定提供依据。方法 2009年10-11月,采取分层随机整群抽样的方法,对舟山及温州市的农村老年人进行入户问卷调查,调查的主要内容包括一般人口学资料、家庭基本情况、就医的可及性、卫生服务需求和利用。并对老年人2周患病率、就诊率、1年内的住院情况及影响住院因素、医疗费用等进行分析。结果调查2184名老年人,2周患病率为53.9%,其中慢性病延续到2周内的占83.4%,患病就诊率为81.7%。就诊首选的医院是村卫生室和镇卫生院,占74%,选择上述医院的主要原因是距离近(占57.1%);调查前一年内住院率为14.3%,选择在县医院、市及以上医院的分别占44.3%、44.2%。2周医疗费用支出中位数为70元,因经济困难未治疗者占24.2%;调查前一年内住院费用的中位数是7000元。在住院患者中,家庭收入低者明显低于中等收入者。结论慢性病是影响农村老年人健康的主要原因;经济状况是影响老年人就医的主要因素;老年人门诊医疗主要考虑方便性,住院医疗首选县级以上医院。
Objective To understand the utilization of health services and the burden of medical expenses for the elderly in rural areas in Zhejiang Province and provide the basis for the formulation of relevant measures. Methods From October to November in 2009, stratified stratified random cluster sampling method was used to survey the rural elderly in Zhoushan and Wenzhou City. The main contents of the survey include general demographic data, family status, medical treatment Sexual, health service needs and utilization. The prevalence rate of 2 weeks in the elderly, visiting rate, hospitalization in 1 year, factors influencing hospitalization, medical expenses and so on were analyzed. Results A total of 2184 elderly people were surveyed. The prevalence rate of 2 weeks was 53.9%, of which 83.4% were chronic diseases within 2 weeks and the prevalence rate was 81.7%. The preferred hospitals for treatment were village clinics and township hospitals, accounting for 74% of the total. The main reasons for choosing the above hospitals were short distance (57.1%); the rate of hospitalization in the previous year was 14.3% The hospitals accounted for 44.3% and 44.2% respectively. The median cost of medical expenses in the two weeks was 70 yuan, 24.2% of the patients were untreated due to financial difficulties. The median hospitalization cost in the previous year was 7,000 yuan. Among hospitalized patients, the lower the family income is obviously lower than the middle income group. Conclusions Chronic disease is the main reason that affects the health of the elderly in rural areas. The economic status is the main factor affecting the elderly. The outpatient service for the elderly mainly considers the convenience. The hospital above county level is the first choice for hospitalization.