目的了解我国农村居民日常医疗费用支出情况,并提出相应政策建议。方法于2015年7—9月,通过乡村一体化管理系统收集安徽省长丰县西部某村卫生室2010—2014年的全部门诊记录,共38 112份。计算该村卫生室的就诊人次、医疗总费用、药品费用、统筹支付费用、人均医疗费用、人均药品费用、药占比及补偿比,并分析不同年龄和不同疾病患者的日常医疗费用支出情况。结果 2010—2014年的就诊人次分别为5 199、6 330、8 423、9 289、8 871人次(男性多于女性),人均医疗费用分别为38.3、25.6、27.6、28.6、26.1元/人次,平均药占比为75.8%,补偿比分别为0.21、0.26、0.49、0.47、0.46。婴幼儿、少年、青年、中年、老年居民的就诊人次分别为3 483、6 182、6 630、14 272、7 545人次,其中老年居民的人均医疗费用为31.7元/人次,药占比为0.78,补偿比为0.36。就诊人次排在前3位的疾病类别分别为呼吸系统疾病(19 444人次)、消化系统疾病(5 702人次)、循环系统疾病(3 569人次),人均医疗费用排在前3位的疾病类别分别为内分泌/营养和代谢疾病(43.6元/人次)、血液及造血器官疾病(41.0元/人次)、循环系统疾病(34.2元/人次),药占比排在前3位的疾病类别分别为内分泌/营养和代谢疾病(0.86)、血液及造血器官疾病(0.80)、循环系统疾病(0.79),补偿比排在前3位的疾病类别分别为传染病和寄生虫病(0.46)、症状/体征等(0.43)、眼和附器疾病(0.43)。共核算出757种疾病,就诊人次排在前10位的分别为感冒(11 065人次)、支气管炎(3 901人次)、扁桃体炎(2 992人次)、消化不良(2 343人次)、贫血(1 266人次)、高血压(1 189人次)、胃炎(916人次)、咳嗽(840人次)、心脏病(788人次)、尿道炎(602人次)。结论2010—2014年村卫生室的就诊人次及医药费用呈总体上升趋势,就诊
Objective To understand the current situation of daily medical expense of rural residents in China and put forward corresponding policy recommendations. Methods From July to September 2015, through the rural integrated management system,we collected all the 2010—2014 outpatient records of a village clinic in west Changfeng County in Anhui Province and finally got 38 112 records. We calculated the village clinic visits number,total medical costs,drug costs,overall pay fees,medical expenses per capita,drug expenses per capita,drugs proportion and compensation ratio,and analyzed daily medical expenses situation of patients of different ages and with different diseases. Results The number of patients visiting a doctor from 2010 to 2014 was 5 199,6 330,8 423,9 289,8 871 respectively( males outnumbered females), medical expenses per capita was 38. 3,25. 6,27. 6,28. 6,26. 1 yuan / person respectively, average drug proportion accounted for75. 8% with a compensation ratio of 0. 21,0. 26,0. 49,0. 47,0. 46 respectively. The number of visiting a doctor of infants,juveniles,youths,middle aged,elderly residents was 3 483,6 182,6 630,14 272,7 545 respectively,the medical expense of the elderly residents per capita was 31. 7 yuan / person,the ratio of drugs accounted for 0. 78,and the compensation ratio for0. 36. Concerning the number of visiting a doctor, the top three disease categories were respiratory system diseases( 19 444cases),digestive system diseases( 5 702 cases),and circulatory system diseases( 3 569 cases); concerning the medical expenses per capita,the top three disease categories were endocrine / nutritional and metabolic diseases( 43. 6 yuan / person),blood and hematopoietic organs diseases( 41. 0 yuan / person),circulatory system diseases( 34. 2 yuan / person); concerning the drugs proportion,the top three disease categories were endocrine / nutritional and metabolic diseases( 0. 86),blood and hematopoietic organs diseases( 0. 80),circulatory system diseases( 0. 79); con