保定市城市居民卫生服务利用公平性分析

目的　了解保定市居民卫生服务利用 (包括社区卫生服务利用 )的公平性情况。方法　通过两阶段抽样方法 (随机整群抽样和系统抽样 )调查了河北省保定市南市区、北市区和新市区 3个区的 962户居民的卫生服务利用情况 ,采用调查表的方式入户调查 ,并将被调查家庭分成 3组 :相对贫困组、贫困临界组和一般家庭组进行公平性分析。结果　一般家庭组中医疗费用支付自费者占 41 0 % ;而相对贫困组为 61 1 % ,贫困临界组为 65 3 % ;相对贫困组年住院率为 1 9 86 % ,贫困临界组为 4 2 9% ,一般家庭组为 7 2 7%。 3组人群两周就诊率分别为 1 9 86 %、 1 0 71 %和 7 66 % ;3组人群的年人均自负医疗费用占年人均收入的比例分别为 2 4 5 %、 2 68%和 1 55 % ;相对贫困组和贫困临界组家庭中接受心理咨询家庭数所占比重分别为 4 76 %和 6 82 %。结论　 (1 )相对贫困人群的卫生服务需求较大 ,但医疗费用支付能力较弱 ,相对贫困人群的医疗疾病负担较重 ;(2 )不同经济条件人群的综合社区卫生服务利用差异不大。

Analysis of the equity of utilization of health services of urban residents in Baoding City

Objective To know about the equity of health services utilization (including community health services utilization) of Baoding City.Methods 962 households in Baoding City were selected for the household survey through two stage sampling method_random cluster sampling and systematic sampling.And the households were divided into 3 groups for the equity analysis.Results The percentage of those who have no insurance in the general group is 41 0%,much lower than those of the critical relatively poor group and the relatively group which are around 60 percent.As to the inpatient services utilization,the number of hospital admissions per 100 persons of the general group in year 2000 is 7 27,much lower than that of the relatively poor group which is 19 86.The number of outpatient visits per 100 persons in the previous two weeks of relatively poor group is 19 86,much higher than that of the other two groups.The percentages of the medical fees out of pocket of three groups in terms of annual income are 24 5%,2 68% and 1 55% respectively.There is little difference in community health services utilization among different groups,except psychological consultation,whose reception percentages of the households of the first two groups are 4 76% and 6 82% respectively,greater than that of the general group.Conclusion (1)The poor has greater needs of health services and heavier burden of disease,but their ability to pay is lower than others.(2)There is little difference in the utilization of the community health services among the crowds of different income level.