湖北省西部某市家庭灾难性卫生支出及影响因素分析

摘要

目的:了解湖北省西部某市家庭灾难性卫生支出发生情况,探究主要影响因素.方法:2014年和2015年,分别对3个乡镇进行入户调查,测算家庭灾难性卫生支出发生率、发生强度及集中指数;运用二项Logistics回归,分析灾难性卫生支出发生的主要影响因素.结果:2014年和2015年样本地区总体灾难性卫生支出发生率分别为23.68%和26.9%%,且差异没有统计学意义(P=0.186);不同经济水平家庭的灾难性卫生支出发生率和平均差距随着收入的提高呈下降趋势;家庭就业比例、住院次数、家庭老年人比例、家庭收入水平是家庭灾难性卫生支出发生的主要影响因素.结论:调研地区的灾难性卫生支出发生状况有待改善,应提高居民收入、加强人群尤其是老年人群的疾病预防控制、提高居民住院的实际补偿比例、加大对贫困和发生高额医疗费用家庭的补偿和补助力度,降低灾难性卫生支出.%Objective: To assess the occurrence of family catastrophic health expenditure (CHE)in a city in the West of Hu-bei Province and find out the determinants.Methods:Carrying out the household investigation of three towns in the district in 2014 and 2015 respectively to calculate the incidence, intensity and concentration index of family CHE.Using binary logistic regression to identify the determinants of CHE.Results:The overall incidences of CHE in 2014 and 2015 were 23.68%and 26.9%respective-ly, and the difference was not statistically significant(P=0.186).The incidence of CHE and the average gap between different in-come level families decreased with the increase of income.Employment ratio, number of hospitalized patients, ratio of elderly in the family, and level of family income appeared to be the main determinants of CHE .Conclusion:The CHE in the region needs to be improved.We should increase the income of residents, strengthen disease prevention and control especially in the elderly popula-tion, improve the actual compensation ratio of hospitalization, increase compensation and subsidies of the families with poverty and high medical costs and other measures, so as to reduce the occurrence of CHE.