摘要
目的了解河南省中老年人群医疗保险使用和医疗费用支出情况,为完善国家基本医疗保险制度,提高国民健康水平提供参考依据。方法于2013年8月采用方便抽样方法在河南省洛阳市、焦作市和信阳市抽取的50个社区1 464名≥45岁中老年人群进行问卷调查。结果河南省1 464名≥45岁中老年人群中,调查前1年接受住院治疗、门诊治疗和自我治疗者分别为582例(39.8%)、1 134例(77.5%)和1 215例(83.0%);在住院治疗、门诊治疗和自我治疗的老年人中未使用医疗保险者分别为37例(6.4%)、666例(58.7%)和928例(76.4%)。河南省中老年人群治疗丧失的收入、保险支付的费用、总费用和净费用支出分别为(749.2±4 020.9)、(3 194.4±8 725.1)、(10 828.2±27 292.5)和(7 023.0±21 919.1)元;使用医疗保险者住院治疗总人群中治疗丧失的收入、净费用和自我治疗中净费用支出分别为(884.2±2 864.0)、(8 555.0±16 401.3)和(674.6±1 753.4)元,均低于未使用医疗保险者的(2 182.4±9 912.2)、(22 230.5±67 633.4)和(1 211.8±2 258.1)元,差异均有统计学意义(均P<0.05)。结论河南省中老年人群在门诊治疗和自我治疗中不使用医疗保险者较多,而使用医疗保险可降低中老年人群住院治疗的治疗丧失收入和净费用及自我治疗的净费用支出。
Objective To identify the characteristics associated with health insurance utilization and the association between the utilization and medical expenditure among middle-aged and elderly population in Henan province and to provide evidences for improving the process of national basic medical insurance.Methods A questionnaire survey among 1 464 community residents aged 45 years and above was conducted in three cities of Henan province in August 2013.Results Of the participants,582（39.8%）,1 134（77.5%）,and 1 215（83.0%）reported inpatient treatment,outpatient treatment and self-treatment during previous 12 months.Among the participants reporting different medical treatments,37（6.4%）,666（58.7%）,and 928（76.4%）didn’t use health insurance for their inpatient,outpatient,and self-treatment,respectively.For all the participants during the previous one year,the average individual medication related lost income,medical cost paid by insurance,gross total cost,and out of pocket cost were 749.2±4 020.9,3 194.4±8 725.1,10 828.2±27 292.5,and 7 023.0±21 919.1 yuan（RMB）,respectively;the participants,who utilized health insurance for their inpatient treatment,reported significantly lower lost income（884.2±2 864.0 vs.2 182.4±9 912.2）,gross total cost（8 555.0±16 401.3 vs.22 230.5±67633.4 yuan）,and out-of-pocket cost（674.6±1 753.4 vs.1 211.8±2 258.1 yuan）compared to those who did not utilize medical insurance for their inpatient treatment（P〈0.05 for al）.Conclusion In Henan province,many middle-aged and elderly people didn’t use health insurance for their outpatient treatment and self-treatment,and the utilization of health medical insurance can reduce lost income,gross total cost,and out-of-pocket cost related to their inpatient medication.
作者
马晨瑾
王瑜
蒋妍
李扬
张育铭
王晓军
马双鸽
MA Chen-jin, WANG Yu, JIANG Yan, et al(School of Statistics and The Center for Applied Statistics, Renmin University of China, Beo＇ing 100872, Chin)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2018年第5期655-659,共5页
Chinese Journal of Public Health
基金
中国人民大学科学研究基金(中央高校基本科研业务费专项资金资助)(16XNI008)
关键词
医疗保险
医疗费用
中老年人群
health insurance
medical expenditure
middle-aged and elderly people
