居民对新医改政策绩效的评价分析

目的:调查分析居民对新医改政策绩效的评价,为卫生决策部门调整和完善卫生政策措施提供循证依据。方法:采用自行设计的《城乡居民新医改政策绩效评价调查问卷》,使用便利抽样的方法,对以安徽省为主的包括18个省市的3511名城乡居民进行入户调查。结果:3 501人中有921人(26.3%)认为目前的医药卫生政策是公平的;3 497人中有1 155人(33.0%)认为医药卫生政策总体上是有效率的;3506人中有838人(23.9%)认为在医改中公平最重要,558人(15.9%)认为效率最重要,2110人(60.2%)认为都重要;3 500人中有366人(10.5%)认为医疗卫生体制改革监管体系是完善的;3 492人中有662人(19.0%)认为目前的医药卫生体制改革总体上来说是成功的;3 435人中有1 141人(33.2%)认为我国医疗卫生体制改革政策的公益性有可能实现;3 493人中有755人(21.6%)对目前的医药卫生体制改革满意,629人(18.0%)不满意;不同性别居民对题项“您认为我国医疗卫生体制改革政策的公益性有可能实现吗?”的评价无统计学意义(P>0.05),对其他7个题项的评价均有统计学意义(P<0.05～P<0.01);不同学历层次居民对“您认为在医改中最重要的是公平还是效率?”的评价无统计学意义(P>0.05),对其他7个题项的评价均有统计学意义(P<0.01);不同年龄段居民对8个题项的评价均有统计学意义(P<0.01)。结论:医改成效与社会期望之间存在一定差距;居民追求医改中的公平、效率和公益性,希望进一步完善医疗卫生体制改革的监管体系。

The evaluation of residents on the new medical reform policy performance

Objective:To investigate the residents evaluation on new medical reform policy performance for providing the evidence in adjusting the public health and improving the health policy measure of decision-making department.Methods:Three thousand five hundred and eleven urban and rural residents from 18 provinces and cities mainly in Anhui province were investigated using the self-designed "the Questionare on New Medical Reform Policy Performance from Urban and Rural Resident's Evalution" by a convenience sampling method.Results:Nine hundred and twenty-one people in 3501 people(26.3%) believed that the current medical and health policy were fair;1155 people in 3497 people(33.0%) thought that the medicine and health policy were generally efficient.Eight hundred and thirty-eight people in 3506 people(23.9%) believed that the equity was the most important in health reform,558 people(15.9%) believed that the efficiency was the most important,and 2 110 people(60.2%) thought that both were important.Three hundred and sixty-six people in 3500 people(10.5%) thought that the medical and health reform and supervision system were perfect,662 people in 3492(19.0%) believed that the current health system reform was generally successful,1141 people in 3435 people(33.2%) thought that the Chinese medical and health system reform welfare policy was likely to achieve.Seven hundred and fifty-five people in 3493(21.6%) were satisfied with the current health system reform,629 people(18.0%) were not satisfied.The evaluation differences of both genders on "Do you think Chinese medical and health system reform welfare policy is likely to be achieved?" were not statistically significant(P>0.05),but they had statistically significant on the ther seven questions(P<0.05 to P<0.01).The evaluation differences of different educational levels on"What do you think is the most important thing in the health reform,fairness or efficiency?" were not statistically significant(P>0.05),but they had statistically significant on the other seven questions(P<0.01). The evaluation differences of different ages on all questions were statistically significant(P>0.05).Conclusions:There is a certain gap between the medical reform effects and social expectations.Residents pursue the fairness,efficiency and public welfare in medical reform,and they hope to further improve the medical and health reform's supervision system.