CAJ | 학술논문

目的：分析新医改前后农村家庭灾难性卫生支出的变化，探讨发生灾难性卫生支出的影响因素。方法：利用陕西省第4次和第5次卫生服务调查数据，以灾难性卫生支出发生率、平均差距和相对差距为测量指标，采用Logistic回归模型分析发生灾难性卫生支出的影响因素。结果：与2008年相比，2013年灾难性卫生支出发生率和平均差距均有下降，相对差距略有上升。当灾难性卫生支出界定标准为40％时，灾难性卫生支出发生率从19．43％降为17．29％，平均差距从3．14％降为2.93％，相对差距则从17．15％上升为17．55％。家庭灾难性卫生支出发生与家庭成员是否患有慢性病、是否有住院利用、是否有65岁及以上老人等因素显著相关。结论：建议加强农村老年居民的慢性病防治工作，同时进一步提高新农合保障水平。
목적：분석신의개전후농촌가정재난성위생지출적변화，탐토발생재난성위생지출적영향인소。방법：이용합서성제4차화제5차위생복무조사수거，이재난성위생지출발생솔、평균차거화상대차거위측량지표，채용Logistic회귀모형분석발생재난성위생지출적영향인소。결과：여2008년상비，2013년재난성위생지출발생솔화평균차거균유하강，상대차거략유상승。당재난성위생지출계정표준위40％시，재난성위생지출발생솔종19．43％강위17．29％，평균차거종3．14％강위2.93％，상대차거칙종17．15％상승위17．55％。가정재난성위생지출발생여가정성원시부환유만성병、시부유주원이용、시부유65세급이상노인등인소현저상관。결론：건의가강농촌노년거민적만성병방치공작，동시진일보제고신농합보장수평。
Ob jective: To compare catastrophic health expenditures in rural families before and after China's health care reform and find out factors associated with the catastrophic health expenditure.Methods: Data came from the fourth and fifth household health service surveys in Shaanxi province.The incidence, average gap and relative gap of catastrophic health expenditure were calculated, and Logistic Regression Model was employed.Results:From 2008 to2013 , the incidence and the average gap of catastrophic health expenditure reduced and the relative gap in-creased.The incidence and the average gap of catastrophic health expenditure reduced from 3.14%to 2.93%, respectively, and the relative gap increased from 17.15% to 17.55% .The influencing factors of the incidence of catastrophic health expenditure include whether the family mem-bers have chronic disease, utilize inpatient service and is 65 years old and older et al.Concluis on:Attention should be paid to enhancing the pre-vention and treatment of chronic diseases for rural old people and further increasing the coinsurance rate for people covered by New Rural Coopera-tive Medical Scheme.