黑龙江省家庭健康询问调查分析及卫生服务综合评价

目的:从卫生服务的需方——居民角度出发,通过家庭健康询问调查,重点了解我省居民的卫生服务需求(需要)、利用和费用投入情况,进而分析我省卫生服务状况,评价我省卫生服务水平,最终为我省乃至我国卫生服务事业的改革与发展提供决策依据和政策性建议。方法:抽样调查方法为:以家庭为单位、以人为调查对象的具有省级代表性的多阶段分层整群系统随机抽样,通过样本估计总体;综合分析方法为:描述性分析和比较分析相结合;综合评价方法为:在以主、客观两种赋权方法确定指标权重的基础上,采用层次分析法对居民卫生服务水平进行综合评价。结果:综合分析发现:我省人口老龄化问题总体较轻,但城市老龄化发展较快;我省城市居民失业问题较重;我省城乡居民收支水平差别明显;我省居民因病致贫、因病返贫的问题突出;我省居民卫生服务需要量呈增加趋势;我省居民医疗卫生服务利用较低,城、乡差异明显;卫生服务需求呈现多样化、多层次性;医疗保障覆盖水平较低;居民健康行为和健康环境需进一步改善。政策建议:高度重视城市人口老龄化问题;标本兼治,综合治理,切实解决好因病致贫、因病返贫问题;积极采取有效措施,减少阻碍卫生服务利用的因素,提高卫生服务有效利用率;扩大医疗保险覆盖面,提高健康保障水平;加强健康教育工作。

Analysis of Heilongjiang Household Health Interview Survey and Synthetic Evaluation of Health Services

Objectives From the health service needed aspect-the resident point view, by Household Health Interview Survey, to know mainly the resident's health services demand(need),utilization and expense situation of our province, to analyze ulteriorly the health services status and evaluate its level, and put forward finally the decision-making reference and policy-making suggestion for health services reform and develop of our province and our country. Method The sample and survey method is like this: families are basic sampling units and persons are survey objects, we adopted the multistage and layered, clustered, system and randomized sampling methods and estimated the total through samples. The synthetic analysis method is like this: based on the subjective and objective methods to estimate the indicators' weight, synthetically evaluate the health services status separately by Analytic Hierarchy Process. Results The synthetic analysis shows: the population aging problem of our province is slight; but the aging problem of the city population develops fast; the unemployment problem of city-dweller is rather severe; the difference of income and payout between the city and village resident is rather obvious; the problems of"the disease caused poverty"and"the disease caused re-poverty"are strictness; the residents'health services demand shows increased tendency; the health services utilization level is lower and the difference of it between city and village is obvious; the health services demand is variety and multi-layered; the coverage level of the medical insurance is low; the health behavior of residents and health environment need further improvement. Policy-making Suggestion Attach great importance to the aging problem of city residents; Treat both the incidental and fundamental aspects simultaneously, comprehensive treatment, practically solve the problems of "the disease caused poverty" and "the disease caused re-poverty"; brace up to take effective measure, fall off the hinder factor of health service utilization, enhance the health service effect utilization; expand the coverage area of the medical insurance, improve health care level; reinforce health education work.