流动人口住院医疗服务利用现状及影响因素分析

目的全面了解流动人口住院医疗服务利用现状及住院地点选择、报销比例的影响因素，提高流动人口健康水平。方法基于2014年5月全国流动人口动态监测调查数据，利用SPSS 20.0软件进行统计分析。结果2013年5月-2014年5月，调查对象住院率为3.2%（6 503/200 937），医生诊断需住院而未住院率为0.8%（1 667/200 937）。住院治疗者中，在流入地住院的比例高达71.0%（4 615/6 503）；住院医疗花费差异较大，最高达450 000元，中位数为5 000元；多数人采用新农合出院减免的形式报销住院花费，同时发现有37.1%（2 413/6 503）的人尚未报销住院费用。影响住院医疗服务利用的因素多样，高学历、非农业户口是住院地点选择、报销比例的双重影响因素，医疗保险也是明显影响因素。结论流动人口住院医疗服务利用仍需改善，应从政策制度、宣传教育、人员设施等方面加强工作。

Status and influencing factors of hospitalization service utilization among migrant population

ObjectiveTo examine the status of hospitalization service utilization,including selection of hospitals and ratio of reimbursement for hospitalization cost,and its influencing factors among migrant population for improving health conditions of the migrants.MethodsData on 200 937 migrants aged 15-59 years were extracted from the nationwide dataset of National Migrant Population Dynamic Monitoring Survey held by National Health and Family Planning Commission of China in 2014.The statistics analysis was performed with SPSS 20.0.ResultsAmong all the migrants surveyed,the hospitalization rate was 3.2% and the proportions of the migrants needing hospitalization according to doctors' suggestion but unhospitalized was 0.8% during the period from May 2013 to May 2014.Of all the migrants hospitalized,71.0% (4 615/6 503) had their hospitalization at their immigrant places.The cost for the reported hospitalization varied greatly,with the maximum of 450 000 RMB yuan and a median of 5 000 yuan.A majority of the hospitalized migrants got their reimbursement at the discharge in the form of reduction and exemption supported by New Rural Cooperative Medical System,but 37.1% of the hospitalized migrants were not reimbursed by the time of the survey.Multiple factors showed influences on hospitalization service utilization among the migrants;higher education background and without rural household registration were factors affecting selection of hospitalization place and reimbursement ratio of hospitalization cost;whether participating in medical insurance was a remarkable influencing factor for hospitalization utilization among the migrants.ConclusionThe hospitalization service utilization among migrant population needs to be improved by making relevant policy and regulation,education,human resource development,and facility construction.