中国全科医学Issue(16)：1968-1971,4.DOI:10.3969/j.issn.1007-9572.2015.16.024
北京市不同医疗保险类型中老年居民的社区卫生服务需求和利用情况调查
Demand and Utilization of Community Health Service for Middle and Old Age Residents Registered With Different Types of Medical Insurances in Beijing
摘要
Abstract
Objective To investigate the community health service demands of middle and old age residents registered With different types of medical insurances and the utilization status. Methods We divided Beijing into urban area,combined area of toWn and country and rural area. Using stratified sampling method,We selected tWo communities With better service from each of the three areas and randomly enrolled 2 632 middle and old age residents from the 6 communities from January to November in 2014. The 2 632 residents Were investigated by self - designed questionnaire survey. The data Were collected to compare and analyze the 2 -Week prevalence rate,the prevalence rate of chronic disease,the proportion of subjects choosing community health service settings for the first contact care and the proportion of the cost spent in community health service settings to the average annual outpatient service cost. Results (1)For subjects registered With socialized medicine,urban employees' basic medical insurance,urban residents' basic medical insurance,and the neW rural cooperative medical insurance,the 2 -Week prevalence rates Were 46. 7%,45. 7%,39. 4%and 18. 8% respectively. The subjects With different types of medical insurance Were significantly different ( P <0. 05 ) in 2 - Week prevalence;the subjects registered With neW rural cooperative medical insurance Were significantly different(P<0. 008 3)in 2-Week prevalence from the subjects With other three types of insurance. (2) For the subjects With socialized medicine,urban employees' basic medical insurance,urban residents' basic medical insurance,and the neW rural cooperative medical insurance, the prevalence rates of chronic disease Were 89. 2%、86. 7%、88. 0% and 77. 0%. The subjects With different types of medical insurance Were significantly different ( P < 0. 05 ) in the prevalence rate of chronic disease. (3)For the subjects With socialized medicine,urban employees' basic medical insurance, urban residents' basic medical insurance, and the neW rural cooperative medical insurance, the rate of choosing community health service settings for the first contact care Were 52. 3%(111/212),64. 2%(305/475),65. 8%(811/1 232)and 77. 1%(489/634). The subjects With different types of medical insurance Were significantly different(χ2 =71. 00,P<0. 05) in the proportion of choosing community health service settings for the first contact care. ( 4 ) The annual average outpatient expenses of the subjects With socialized medicine,urban employees' basic medical insurance,urban residents' basic medical insurance,and the neW rural cooperative medical insurance Were ¥ 9 553. 7, ¥ 8 660. 7, ¥ 8 846. 7 and ¥ 4 246. 0. For the four types of insurance,the proportion of subjects Who spent more than 50% of the annual outpatient cost on community health service Were 32. 1% ( 68/212 ), 33. 5% ( 159/475 ), 30. 9% ( 381/1 232 ) and 44. 5% ( 282/634 ) respectively. Conclusion The health service demand of the middle and old age residents in Beijing is relatively high. Community health services play a positive role in guiding the medical choice of middle and old age residents,Which helps control their annual average outpatient cost to some extent. The capacity of community health service settings needs to be further improved. The financing standards and compensation levels of different types of medical insurance should be integrated in order to ensure residents have equitable and equal access to health service.关键词
中老年居民/保险,长期医疗/社区卫生服务Key words
Middle and old age residents/Insurance,long-term care/Community health services分类
医药卫生引用本文复制引用
纪瑞云,朱兆芳,王亚,刘丽娜,孙广宁,杨金侠..北京市不同医疗保险类型中老年居民的社区卫生服务需求和利用情况调查[J].中国全科医学,2015,(16):1968-1971,4.基金项目
北京市科技计划项目 （）
