安徽省繁昌,铜陵两县住院服务分析

在安徽省繁昌与铜陵两县进行为期4周的住院病人调查中,共访问了777名住院病人,男性占56.6％,年龄主要分布在20～40岁,以农民为主,多是初、高中文化程度的自费病人;85.76％的住院病人来自县医院,内科住院病人占多数,病种主要集中在呼吸系统疾病及消化系统疾病。平均每次住院费用为 825.29元,其中药费占 339.19元,为41.1％,次均住院天数为9.17天,日均住院费用为90.00元,日均住院药费为36.99元。单因素分析结果表明,次均住院费用、住院天数与日均住院费用都与病人的社会经济学特征有一定的联系,也与医疗机构、病种及住院科室有一定的关系。不同医疗保健制度对次均住院费用及次均住院天数都有影响,最高为公费与劳保病人,而自费病人的住院费用则处于低水平。另外还发现县医院的住院费用与住院天数都高于乡镇卫生院,以及排在前3位的高住院费用病种为肿瘤、循环系统疾病与消化系统疾病。多因素分析表明,县医院、内科、年龄、自费与离退休对次均住院费用有作用,其中内科与自费这两项因素为负向作用,县医院、离退休与年龄对住院费用为正向作用。说明了自费制度在一定程度上抑制了病人的支付能力,不利于保障人民的健康水平。

Inpatient Service Analysis at Fanchang and Tongling Counties in Anhui Province

777 inpatients at Fangchang and Tongling counties in Anhui province were interviewed during four weeks from April 8. 1996 to may 4 1996. 56. 6% of them were male, most of them were aged 20 to years old and non-insured farmers. 85. 76% of them were at county hospital and most of them were at the department of medicine, the mostcommon diseases were the circulatory system diseases and respiratory system diseases. The average inpatient fees were 825. 29 yuan, in which, 339. 19 yuan were drug fees, the average stay length was 9.17days, inpatient fees per day were 90. 00 yuan and drug fees per day were36. 99 yuan. The results of single factor analysis showed that there were relations between average inpatient fees, stay length and patient's social and economic characteristics, the types of diseases, hospitals and departments. There were differences between health financing systems, the patients covered by government and labor insurances had the highest fees and stay length, but non-insured patients had lower fees. Other findings were the fees and stay length were higher in county hospital and the highest fees by diseases were tumour, the circulatory system diseases and respiratory system diseases. Multi-variate analysis showed that user fees and the department of medicine had the negative effects on the inpatient fees, and age, county hospital and retired people had the positive effects on the fees. This pointed out that user fees would not protect people's health to a certain degree.