摘要
目的 :了解西部地区不同收入人群的健康差异 ,为今后的卫生机构改革和卫生资源配置提供依据。方法 :利用卫生部世界银行秦巴扶贫项目基线调查资料 ,涉及陕西、宁夏和四川 2 6个县 45 885人 ;按照家庭年人均收入将调查人群分为 5组 ,利用极差指标 (比值比OR和率差RD)和集中指数 (C)计算不同收入人群门诊服务和住院服务利用的不公平程度。结果 :不同人群标准化就诊率的集中指数男性为 - 0 .0 86 ,女性为 - 0 .0 5 1,与标准化患病率的集中指数之差男性为 - 0 .0 32 ,女性为 - 0 .0 0 8;标准化年住院率的集中指数男性为 - 0 .0 2 5 ,女性为 - 0 .0 2 2 ,与标准化年应住院率的集中指数之差男性为 0 .15 8,女性为 0 .112。结论 :无论男女在门诊和住院卫生服务利用上均表现为低收入人群利用水平高 ,虽然与其需求相比 ,不同收入人群门诊服务的利用水平差别不大 ,但是低收入人群得到的卫生服务质量较差 ;而低收入人群住院服务无论是利用水平还是得到的服务质量均低于高收入人群 ,均存在不公平。
Objective: To investigate the status of equity in health care in western poverty stricken areas of china. Methods:Based on the baseline data of Qinba Mountains Poverty Reduction Project, which involved 45885 people of 26 counties in Shaanxi Province, Ningxia Hui Autonomous Region and Sichuan Province, the population were divided into income quintiles according to the family income per year. And then the study measured inequalities in the utilization of and expenditure of health care through Range (OR and RD) and Concentration index(C). Results: The C of age standard consulting rate for males and females was -0.086 and -0.051 respectively. The difference between the C of age standard morbility rate and that of age standard consulting rate was -0.032 for males, and -0.008 for females. The C of age standard inpatient rate was -0.025 for males, and -0.022 for females; the difference between age standard need inpatient rate was 0.158 and 0.112 for males and females respectively. The results indicate: There was inequity in utilizing health care. People with lower income received higher outpatient and inpatient health care, which might be due to the higher demand for health care. The ratio of people consulting and hospitalized at county hospital and higher level was lower in the lower income groups than that in the higher income groups. The expenditure of health care among lower income groups was also less than that among higher income people. Conclusion: These results show that lower income patients cannot receive suitable health care corresponding to their need, the need for health care cannot be met mainly due to poverty.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2001年第6期501-506,共6页
Journal of Peking University:Health Sciences
关键词
卫生资源
卫生服务
卫生计划资助
卫生机构
Health care rationing
Health resources
Health services
Health planning support
