城市低保家庭灾难性卫生支出现状及影响因素实证分析

目的:了解城市贫困家庭灾难性卫生支出现状,分析其影响因素,并提出针对性的措施。方法:采用自行设计的问卷,采用系统抽样的方式对样本市的1 100户获得国家最低生活保障的家庭进行了调查。数据分析方法包括统计描述、logistic回归模型等。结果:调查家庭灾难性卫生支出发生率为59.15%;影响调查地区低保人群灾难性卫生支出发生的主要因素包括家庭成员最高文化程度、家庭成员患慢性病和住院服务利用状况、医疗救助知晓和利用情况、家庭经济状况。结论:调查低保家庭的灾难性卫生支出发生率极高;慢性病对调查地区低保家庭灾难性卫生支出的影响较大。因此,应进一步完善医疗救助制度、强化低保人群的慢性病社区管理、改善家庭经济状况以降低低保人群灾难性卫生支出。

Analysis on the Status and Influencing Factors of Catastrophic Health Expenditure in Poor Urban Families

Abstract: Objective: To understand the status of catastrophic health expenditure in poor urban families, analyze the influencing factors, and put forward the pertinence measures. Methods: 1100 families who received subsistence security in A City in Jilin Province were investigated by system sampling method with a self-designed questionnaire. The data analysis methods include chi square test, logistic regression model,etal. Results: The median of household expenditure on household health expenditure was 50%.Catastrophic health expenditure rate was 59.1%. The rate of proportion of self payment of cash expenditure on chronic disease for household cash health expenditure reached 0.9~1.0 was 33.5%.Influencing factors of catastrophic health expenditure for poor urban families were the highest cultural degree in family members, family members suffering from chronic diseases , hospitalization services utilization, awareness and utilization of medical assistance, family economic status. Conclusion: The household health expenditure and the rate of catastrophic health expenditure for poor urban families were very high. Chronic diseases gave great impacts on poor urban families. It was necessary to develop the medical assistance system, strengthen the community management of chronic diseases and improve the family economic conditions to reduce the catastrophic health expenditure.