安徽省三县农村居民卫生服务需求研究

对安徽省三个世行贷款卫Ⅷ项目县 1 80 0户 71 75名农村居民卫生服务需求进行了调查分析。结果显示 :两周就诊率为 2 1 .76 % ,平均就诊次数 2 .2 3 ,未就诊率 1 2 .50 % ;两周患病首次就诊单位分布村级卫生机构占 77.80 % ,乡镇卫生院占 1 4 .90 % ;年住院率为 3 .2 8% ,因经费困难延迟入院或提前出院者占全部住院者的 60 .60 % ,应住院未住院率为 53 .91 % ;居民对卫生服务利用的主要障碍是住院服务得不到经济保障。建议贫困地区卫生机构的布局与调整应以保障居民获得就近、低廉、方便的卫生服务为目标 ;改善卫生服务质量应以加强村级卫生机构管理为重点 ;实施合作医疗保险及医疗救助应以住院补偿为主。

Study on Health Service Demand of Rural Residents in Three Poor Counties of Anhui Province

A total of 1800 households (involving 7175 rural residents) were chosen from 3 Health Project VIII counties in Anhui Province to conduct a survey on health service demand. The survey revealed that 21.76% of the subjects had consumed medical care within the past two weeks; average number of visits to doctors was 2.23 times; 12.50% of the cases had not seen doctors. 77.80% of the respondents chose to visit village clinics for the time when they become ill; while 14.90% chose to visit township health centers firstly. Average annual hospitalization rate was 3.28%. 53.91% of the patients who need hospitalization had not hospitalized. Patients who delayed admission to and early discharged from hospitals due to financial reasons accounted for 60.60% of all inpatients. The main problem to utilize health services by the local residents is that they cannot afford to get inpatient care.Thus,we suggest that reformation of health service institutions in poor areas should aim at providing local residents with cheap and convenient services; quality improvement should emphasize village-level health services; and development of Cooperative Medical Systems and Medical Financial Assistance should give priority on reimbursing inpatient care.