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目的比较医改前后重庆市城乡老年人的住院服务利用变化情况,评价医改政策在此方面的实施效果,为进一步完善相关卫生政策提供依据。方法利用第四次和第五次中国西部地区卫生服务调查资料,对重庆市2008年和2013年的城乡老年人住院服务利用数据进行分析。结果 2008-2013年重庆市城市老年人的整体住院率从14.91%上升到19.18%,其中低收入人群的住院率从12.30%上升到20.29%,慢性病患者的住院率从17.96%上升到26.05%;城市老年人的应住院而未住院率从40.10%下降到17.35%。农村老年人的整体住院率从13.73%上升到18.02%,其中低收入人群的住院率从10.95%上升到18.59%,慢性病患者的住院率从18.40%上升到25.57%;农村老年人的应住院而未住院率从52.19%下降到27.00%。结论与2008年相比,2013年重庆市城乡老年人整体住院率上升,尤其是低收入人群和慢性病患者的住院率增加显著,应住院而未住院率大幅下降,但是城乡老年人在住院服务利用上仍然存在明显差距,说明医改政策对于提高重庆市城乡老年人整体住院服务利用的效果明显,但是仍有局限性。
Objective To compare the changes of inpatient service utilization of urban and rural elderly in Chongqing before and after medical reform and to evaluate the effect of medical reform in this aspect and to provide basis for further improvement of relevant health policies. Methods Based on the fourth and fifth survey data of health services in western China, the data of inpatient service utilization of urban and rural elderly in Chongqing in 2008 and 2013 were analyzed. Results In 2008-2013, the overall hospitalization rate of urban elderly in Chongqing increased from 14.91% to 19.18%. The rate of hospitalization for low - income population increased from 12.30% to 20.29% and the rate of hospitalization for chronic patients increased from 17.96% to 26.05%. Urban elderly should be hospitalized without hospitalization rate dropped from 40.10% to 17.35%. The overall rate of hospitalization for the elderly in rural areas increased from 13.73% to 18.02%, among which the rate of hospitalization for low-income people increased from 10.95% to 18.59% and that for chronic patients rose from 18.40% to 25.57%. In rural areas, the elderly should be hospitalized The unincorporated rate decreased from 52.19% to 27.00%. Conclusions Compared with 2008, the overall hospitalization rate of elderly persons in urban and rural areas in Chongqing increased in 2013, especially in low-income groups and chronic diseases. There was a significant increase in hospitalization rate but no significant decrease in hospitalization rate. However, in urban and rural elderly people, There is still a significant gap, indicating that health reform policies for improving the overall urban and rural residents in Chongqing overall service utilization effect is obvious, but there are still limitations.