【摘要】：目的:分析城鎮(zhèn)職工醫(yī)保、城鎮(zhèn)居民醫(yī)保和新型農(nóng)村合作醫(yī)療覆蓋人群門診和住院服務利用的公平性。方法:利用2014年浙江、江蘇、安徽、湖南、青海和內(nèi)蒙古的家庭健康詢問調(diào)查數(shù)據(jù),采用間接標化法計算不同經(jīng)濟收入人群門診及住院服務利用的比例及相應的集中指數(shù)。結果:城鎮(zhèn)職工醫(yī)保、城鎮(zhèn)居民醫(yī)保和新型農(nóng)村合作醫(yī)療覆蓋人群的兩周就診次數(shù)標化后集中指數(shù)分別為0.061、0.021、0.036,顯示城鎮(zhèn)居民醫(yī)保人群門診利用公平性優(yōu)于新型農(nóng)村合作醫(yī)療和城鎮(zhèn)職工醫(yī)保人群;年住院次數(shù)標化后集中指數(shù)分別為0.043、0.103、0.071;年住院天數(shù)標化后集中指數(shù)分別為0.074、0.192、0.133,顯示城鎮(zhèn)職工醫(yī)保人群住院服務利用公平性好于新型農(nóng)村合作醫(yī)療和城鎮(zhèn)居民醫(yī)保人群。結論:門診統(tǒng)籌可提高居民就醫(yī)的公平性,住院服務利用公平性與醫(yī)保報銷水平、醫(yī)保制度設計和經(jīng)濟發(fā)展水平相關。
[Abstract]:Objective: to analyze the equity of outpatient and inpatient service utilization of urban employee medical insurance, urban resident medical insurance and new rural cooperative medical care. Methods: based on the data of family health survey in Zhejiang, Jiangsu, Anhui, Hunan, Qinghai and Inner Mongolia in 2014, the proportion of outpatient and inpatient service utilization and the corresponding concentration index were calculated by indirect standard method in Zhejiang, Jiangsu, Anhui, Hunan, Qinghai and Inner Mongolia. Results: medical insurance for urban workers, The standard index of two weeks' consultation frequency of urban residents' medical insurance and new rural cooperative medical care was 0.061 / 0.021 / 0.036, respectively, which indicated that the equity of outpatient utilization of urban residents' medical insurance was better than that of the new rural cooperative medical care and the urban workers' medical insurance. The standard index of annual hospitalization times was 0.043 / 0.103n / 0. 071, respectively, and the standard index of annual hospitalization days was 0.074 / 0.192 / 0.133, respectively, which indicated that the equity of hospitalization service utilization of urban staff and workers was better than that of the new rural cooperative medical care system and the urban residents' medical insurance system. Conclusion: outpatient coordination can improve the fairness of residents seeking medical treatment, and the fairness of hospitalization service utilization is related to the level of medical insurance reimbursement, the design of medical insurance system and the level of economic development.
【作者單位】： 新疆石河子大學醫(yī)學院預防醫(yī)學系;國家衛(wèi)生計生委衛(wèi)生發(fā)展研究中心;
【分類號】：R197.1;F842.684

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