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目的 了解保定市居民卫生服务利用 (包括社区卫生服务利用 )的公平性情况。方法 通过两阶段抽样方法 (随机整群抽样和系统抽样 )调查了河北省保定市南市区、北市区和新市区 3个区的 962户居民的卫生服务利用情况 ,采用调查表的方式入户调查 ,并将被调查家庭分成 3组 :相对贫困组、贫困临界组和一般家庭组进行公平性分析。结果 一般家庭组中医疗费用支付自费者占 41 0 % ;而相对贫困组为 61 1 % ,贫困临界组为 65 3 % ;相对贫困组年住院率为 1 9 86 % ,贫困临界组为 4 2 9% ,一般家庭组为 7 2 7%。 3组人群两周就诊率分别为 1 9 86 %、 1 0 71 %和 7 66 % ;3组人群的年人均自负医疗费用占年人均收入的比例分别为 2 4 5 %、 2 68%和 1 55 % ;相对贫困组和贫困临界组家庭中接受心理咨询家庭数所占比重分别为 4 76 %和 6 82 %。结论 (1 )相对贫困人群的卫生服务需求较大 ,但医疗费用支付能力较弱 ,相对贫困人群的医疗疾病负担较重 ;(2 )不同经济条件人群的综合社区卫生服务利用差异不大。
Objective To understand the fairness of the use of health services (including the use of community health services) by residents of Baoding City. Methods Two-stage sampling methods (random cluster sampling and systematic sampling) were used to investigate the health service utilization of 962 households in the three districts of Nanshi District, Beishi District and Xinshi District of Baoding City, Hebei Province. The questionnaires were used. The households surveyed and divided the families surveyed into three groups: the relatively poor group, the critical poverty group, and the general family group. Results In the general family group, 40% of the medical expenses were paid by the self-paying group; 61% were in the relative poor group, 652.3% in the critical poverty group, 9.86% in the relative poverty group, and 42.2 in the poverty critical group. In 9%, the average family group was 7.27%. The two-week consultation rate for the three groups was 198.6%, 107%, and 766.6%; the average annual per capita personal medical expenses for the three groups was 24.5%, 2.68%, and 1 respectively. 55 % ; The proportion of the number of families receiving psychological counseling in the relative poverty group and the critical poverty group was 477 % and 682 % respectively . Conclusions (1) Relatively poor people have a large demand for health services, but the ability to pay for medical expenses is relatively weak, and the medical burden of disease is relatively heavy for the poor. (2) There is little difference in the use of comprehensive community health services among people with different economic conditions.