| 摘要: |
| [摘要]目的 研究农村医疗支出型贫困人群自主要求出院的影响因素，为完善人群医疗保障政策提供依据。方法 采用方便抽样的方法，在四川米易县、江苏滨海县、河北邢台县对453户医疗支出型贫困家庭住院患者进行入户调查，利用卡方检验作单因素影响分析。结果 调查人群就医趋高性明显。24.8%家庭住院费用需他人资助或借贷，7.1%因经济困难自主要求出院。机构、年龄、文化程度、就业、健康自评、家庭人均资产和人均耕地面积、家庭人均年收入和支出、家庭恩格系数、家庭年教育支出与医疗支出占总支出的比例、住院费用及其支出方式、对医生的信任等为全人群自主出院的影响因素。不同地域间自主出院影响因素不同。结论 大病医疗制度建设应具有地域性，关注县医院的支付比例设置，制度的实施对切实解决弱势人群因病致贫、返贫问题有明确的现实意义和预期效果。 |
| 关键词: 农村人口 医疗支出型贫困 医疗费用无力承担 就医选择 |
| DOI：10.16781/j.0258-879x.2016.10.1310 |
| 投稿时间：2015-09-16修订日期：2016-03-19 |
| 基金项目:国家自然科学基金（71203230）. |
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| Sampling investigation on factors influencing patients' request for discharging from hospital in the illness-caused poverty families in rural China |
| TENG Hai-ying1,SUN Ning2,CHEN Qian2,MA Yu-qin2* |
(1. Department of Mathematics and Physics, College of Basic Medical Sciences, Second Military Medical University, Shanghai 200433, China;
2. Department of Health Management, Faculty of Health Services, Second Military Medical University, Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To explore the factors which influence patients in the illness-caused poverty families in rural to request for discharging from hospital so as to provide evidence for perfecting medical security system. Methods By convenience sampling method, 453 inpatients in the illness-caused poverty families were face-to-face interviewed in Miyi County of Sichuan Province, Binhai County of Jiangsu Province and Xingtai County of Hebei Province. Chi-square test was used to assess the affecting factors of respondents’ own request for discharging from hospital. Results Respondents were more likely to choose higher level hospitals, but 24.8% of them needed financial support or loans and 7.1% of them asked for discharging from hospital. The main factors are medical institutions, age, education, employment, self-rated health, the familial asset per capita and average agrarian area, per capita annual incomes and expenditure, Engel coefficient, the proportion of expenditure on education and health care, hospitalization expenses and payment methods, and belief in doctors. Factors in different regions are different. Conclusion The catastrophic health care system should be established according to regional characteristics. More attention must be paid to the ratio of individual payment in county-level hospitals. The implementation of the system has its definite realistic meaning and anticipated effect on effectively solving “sickness poor” and “poverty due to illness” for vulnerable groups. |
| Key words: rural population illness-caused poverty medical indigency medical choices |
