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目的:调查和分析农村高血压和糖尿病患者的就诊行为及医疗负担,提出减轻农村患者的医疗负担和提高基层医疗资源利用率的措施。方法:选择浙江省长兴县农村中老年高血压和糖尿病患者共580例作为研究对象,采用走访和电话访问相结合的方式对患者的就诊行为及医疗负担进行调查分析。结果:96.7%的农村高血压和糖尿病患者选择农村及乡镇医院进行就诊治疗,52.1%的患者选择市级及以上医院进行住院治疗,且市级及以上医院的平均住院费用要远高于乡镇医院。结论:通过加强农村医疗单位建设,提升服务水平和质量,落实双向转诊制度,引导农村患者合理就医,不断提高基层医院对慢性疾病的保障水平,可减轻农村患者的医疗负担和提高基层医疗资源的利用率。
OBJECTIVE: To investigate and analyze the treatment and medical burdens of hypertension and diabetes patients in rural areas and put forward measures to reduce the medical burden on rural patients and improve the utilization rate of primary medical resources. Methods: A total of 580 middle-aged and elderly people with hypertension and diabetes in rural Changxing County of Zhejiang Province were selected as the research object. The visiting behavior and the medical burden of the patients were investigated through the combination of visiting and telephone interview. Results: 96.7% of rural patients with hypertension and diabetes chose rural and township hospitals for treatment, 52.1% of them chose hospitals for municipal treatment or above for hospitalization, and the average hospitalization costs in hospitals at or above the city level were much higher than those in township hospitals . Conclusion: By strengthening the construction of rural medical units, improving the service level and quality, implementing the two-way referral system, guiding rural patients to seek reasonable medical care, and continuously improving the level of protection for chronic diseases in grass-roots hospitals, it can reduce the medical burden on rural patients and improve the level of primary medical resources Utilization rate.