兵团城镇职工基本医疗保险覆盖人口的医疗服务利用变化分析

目的:分析新疆生产建设兵团城镇职工基本医疗保险参保人口医疗服务利用的变化情况,为进一步发展和完善兵团城镇职工基本医疗保险提供依据。方法:利用兵团2004年和2010年两次卫生服务调查资料,对参保人口的卫生服务需要、卫生服务利用和医疗费用变化进行分析。结果:2004年与2010年相比,参保职工两周患病率由211.8‰上升到390.2‰,两周就诊率由81.6‰上升至95.0‰,年住院率由106.9‰上升至145.9‰,未住院率由19.4%下降到14.1%,经济困难是未利用住院服务的主要原因,次均就诊费用年增长率为4.1%,次均住院费用年增长率为5.7%。结论:兵团城镇职工基本医疗保险制度一定程度地促进了职工对门诊及住院医疗服务的利用,但医疗费用增长较快,补偿水平不高,尚不能完全保障职工合理的医疗服务需求。

Analyze The Changes in Health Services Utilization of Population Covered by Medical Insurance for Urban Workers of The Xinjiang Production and Construction Corps

Objective:To analyze the changes in health services utilization of population covered by medical insurance for urban workers of the Xinjiang production and construction corps and to provide scientific basis for the basic medical insurance for urban workers.Methods:By using the data of the health service survey in 2004 and 2010,the changes are analyzed in health service need,health services utilization and medical expenses of urban workers.Results:The two-week prevalence rate increased from 211.8‰ to 390.2‰,two weeks visiting rate increased from 81.6‰ to 95 ‰,annual hospitalization rate increased from 106.9‰ to 145.9‰,and the rate of persons without being hospitalized who need to hospitalize reduced from 19.4% to 14.1%.The main reason for people without being hospitalized was for financial difficulties,the average medical expense per treatment growth increases by 4.1%,and the average medical expense per hospitalization growth increases by 5.7%.Conclusion:The medical insurance for urban workers of Xinjiang production and construction corps plays a certain role on guiding the workers to utilize the outpatient service and the inpatient service,but at the same rapid growth of medical costs,lower levels of compensation of the basic medical insurance for urban workers can’t completely protect the reasonable demand for medical services workers.