新农合农村家庭灾难性卫生支出的影响研究——以湖北省孝昌县为例

目的:研究湖北省孝昌县农村居民灾难性卫生支出的发生情况及其影响因素。方法:采用多阶段分层随机抽样,抽取湖北省孝昌县3镇9村,共约1 168户家庭、4 468人,比较分析新农合补偿前后灾难性卫生支出的发生情况及其影响因素。结果:新农合补偿后,样本地区的灾难性卫生支出发生率、平均差距和相对差距均有所下降;灾难性卫生支出的影响因素有:家庭收入水平、家庭中有工作的成员的数量、家庭成员住院次数、家庭是否有慢性病患者。结论:孝昌县农村地区家庭随着收入水平的增加其灾难性卫生支出的发生率和严重程度均降低,减少该县农村地区灾难性卫生支出应该健全完善新农合对于慢性病门诊费用的补偿机制、降低低收入人群的医疗费用自付比例。

The effects of New Rural Cooperative Medical Scheme on catastrophic health expenditure of rural families:A case study of Xiaochang County in Hubei Province

Objective:To study the incidence of catastrophic health expenditure of rural families in Xiaochang County of Hubei province, in order to explore the influential factors of catastrophic health expenditure. Methods:By using a multi-stage stratified cluster sampling to conduct a household survey, this paper randomly selects a total of about 1,222 households of 4,673 people from 9 villages of 3 different towns in Xiaochang county of Hubei province, in order to compare the rate and severity of catastrophic health expenditure before and after joining the New Rural Cooperative Medical Scheme (NRCMS), and it uses binary logistic regression model to analyze the influential factors of catastrophic health expenditure. Results:After joining the NRCMS, the rate, average gap and relative gap of catastrophic health expenditure have all declined within the sampled areas; the influential factors of catastrophic health expenditure are household income, the number of working family members, the number of hospitalizations in family members, and the number of chronic patients among family members. Conclusion:With the increase of household income in the rural areas of Xiaochang County, both the rate and severity of catastrophic health expenditure have decreased. In order to significantly reduce the catastrophic health expenditure in the rural areas of Xiaochang County, the government should perfectly improve the NRCMS's compensation mechanism for chronic outpatients' costs and reduce the proportion of self-pay patients from low-income families.