上海市周浦社区老年人健康状况与医疗负担

摘要

Objective To investigate the health status and medical care costs of the elderly lived in urban communities in Shanghai and provide evidence for the elderly medicare institution reform .Methods Cluster random sampling method was used to select 367 elderly from communities in a town of Shanghai Pudong district ,and the subjects were surveyed by a self-designed questionnaire .The survey included social demographic characteristics ,health insurance ,chronic disease costs in the past six months ,the hospitalizations and direct medical costs in the last time,and satisfaction with medicare .Results Total 360(98.1%) effective questionnaires were collected .There was certain finan-cial burden for the elderly due to higher chronic medical needs but lower incomes ,even if some percentage of total costs were likely to be cov-ered by health insurance .The situation was even worse in those who hadn't been covered by urban employee medical insurance system .Con-clusions The elderly medicare institution should be perfected further ,the level of medical care for vulnerable groups should be improved , and also prevention and treatment of chronic diseases are essential .%目的：调查上海市城镇老年人口的健康状况及医疗负担。方法采用整群随机抽样的方法抽取上海市周浦社区367名老年人做入户调查。使用自制调查问卷，调查内容包括人口学特征、参保的医疗保险、半年内慢性病医疗消费、一年内住院情况及最近一次住院的医疗消费、对医疗保险的满意度等。结果共获得有效问卷360份，有效率为98．1％。老年人慢性病医疗消费高，虽然通过基本医疗保险已获得较大补偿，但是相对其较低的收入水平，仍有一定的经济负担，尤其是收入和保障相对较低的非城保居民。结论应进一步完善老年医疗保障制度，提高弱势群体的医疗保障水平，同时加强对慢性病的防治。