新型合作医疗对农村老年人门诊服务利用及影响因素研究

利用2002年和2004年东营市卫生服务调查资料．分析了农村老年人门诊服务利用及影响因素。分析结果表明：①农村老年人收入水平较低．医药费支出较高；②97．2％的老年人享受新型合作医疗，社会医疗保险和商业保险仅覆盖2．3％的老年人；③两周就诊率为20．4％。两周患病未就诊率平均为24．5％；④患病未就诊前三位原因是自感病情、经济困难和无有效治疗措施；⑤影响老年人就诊率的主要因素为年龄、职业状况、就诊距离及健康状况。因此，在实施新型农村合作医疗制度实施中，应争取多方筹资，建立老年医疗救助制度，增加卫生服务公平性，提高农村基层技术人员的技术水平。

Effect of the new cooperative medical system on the use of outpatient services by the rural elderly and the influencing factors

Using surveying data on health services in the City of Dongying in 2002 and 2004, the paper analyzes the use of outpatient services by the rural elderly and the influencing factors. It was found that the income level of the rural elderly was low whereas their medical expenditures were high; 97. 2% of them had access to the new type of cooperative medical care while only 2. 3%of them were covered by social medical insurance or commercial insurance. The average rate of their hospital visits in two weeks was 20. 4% and the average rate of their not seeing a doctor when sick in two weeks was 24. 5%, the top three reasons for them not seeing a doctor were the feeling of not being very sick, financial difficulty and lack of effective treatment; the major factors influencing the rate of their hospital visits were age, job status, distance to the hospital, and health status. Thus, in implementing the new rural cooperative medical system, it is necessary to try to raise funds by various means so as to set up a system of medical aid to the elderly, enhance the impartiality of health services, and improve the expertise of medical workers at basic level in rural areas.