Trend of urban-rural disparities in hospital admissions and medical expenditure in China from 2003 to 2011.
Trend of urban-rural disparities in hospital admissions and medical expenditure in China from 2003 to 2011.
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2003-2011年中国住院人数和医疗费用城乡差异变化趋势
DOI：
10.1371/journal.pone.0108571
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Liu M
中科院分区：
文献类型：
--
作者：
Fu R;Wang Y;Bao H;Wang Z;Li Y;Su S;Liu M
目的分析2003 - 2011年中国医疗卫生体制改革背景下城乡住院和医疗费用差距的变化趋势。方法收集2003年第三次全国卫生服务调查、2008年第四次全国卫生服务调查和2011年全国医疗卫生改革阶段性评估调查数据。2003年、2008年和2011年，15岁或以上的受访者分别为151421人、143380人和48356人。结果15岁及以上人群的健康保险覆盖率从2003年的27.7%大幅提高到2011年的96.4%。住院率从2003年的4.1%迅速上升到2011年的9.6%。城市居民住院率高于农村居民，2003年、2008年和2011年住院率的RR（95%CI）分别为1.23（1.17-1.30）、1.06（1.02-1.10）和1.16（1.10-1.23）。随着时间的推移，住院率的城乡差距显著缩小。城市受访者有较高的入学率，如果保险和较低的入学率，如果没有保险比农村同行。在六项医疗支出措施中，报销比例和住院直接费用占总消费支出比例的差距明显缩小。结论医疗保险覆盖面不断扩大，卫生服务利用有了明显提高。城乡差距有所缩小，但依然存在。因此，政策制定者应着力加大投入力度，提高报销水平，建立城乡统一标准的医疗保险制度，完善医疗救助制度。
Objectives To assess the trend of urban-rural disparities in hospital admissions and medical expenditure between 2003 and 2011 in the context of Chinese health-care system reform. Methods The data were from three different national surveys: the Third National Health Services Survey in 2003, the Fourth National Health Services Survey in 2008 and the national health-care reform phased assessment survey in 2011. There were 151421, 143380 and 48356 respondents aged 15 years or older in 2003, 2008 and 2011, respectively. Results The health insurance coverage expanded considerably from 27.7% in 2003 to 96.4% in 2011 among respondents aged 15 years or older. Hospitalization rate increased rapidly from 4.1% in 2003 to 9.6% in 2011. Urban respondents had higher hospital admissions than rural respondents, and the RR (95% CI) of hospitalization was 1.23 (1.17–1.30), 1.06 (1.02–1.10) and 1.16 (1.10–1.23) in 2003, 2008 and 2011, respectively. The urban-rural disparity in hospital admissions significantly narrowed over time. Urban respondents had a higher admission rate if insured and a lower admission if not insured than their rural counterparts. Of the six medical expenditure measures, the disparities in reimbursement rate and the proportion of hospitalization direct cost to the total consumer spending significantly narrowed. Conclusions The health insurance coverage has been continually expanding and health service utilization has been substantially improved. Urban-rural disparities have been narrowed but still exist. Therefore, policy-makers should focus on increasing investment and reimbursement levels, developing a uniform standard health insurance system for urban and rural residents and improving the medical assistance system.
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影响因子：
3.7
作者：
Sun H;Zhang Q;Luo X;Quan H;Zhang F;Liu C;Liu M
通讯作者：
Liu M
影响因子：
2.1
作者：
Lei, Xiaoyan;Lin, Wanchuan
通讯作者：
Lin, Wanchuan
DOI：
10.1016/s0140-6736(08)61364-1
发表时间：
2008-10-25
期刊：
Lancet (London, England)
影响因子：
--
作者：
Tang S;Meng Q;Chen L;Bekedam H;Evans T;Whitehead M
通讯作者：
Whitehead M
影响因子：
6.8
作者：
Dong, Keyong
通讯作者：
Dong, Keyong
影响因子：
168.9
作者：
Yang, Gonghuan;Kong, Lingzhi;Koplan, Jeffrey P.
通讯作者：
Koplan, Jeffrey P.