南京市不同医保人群卫生服务利用分析

目的：分析不同医疗保障人群卫生服务利用的特点，为进一步完善医疗保障制度提供政策依据。方法：采用多阶段分层整群随机抽样的方法，对南京市4873户城乡居民进行入户询问调查。结果：南京市现行医疗保障制度对居民住院服务利用有明显促进作用，但对门诊服务利用的影响则不明显；城区城镇职工基本医疗保险引导居民就医流向的作用不如农村新型合作医疗制度表现明显。结论：政府应加快建立覆盖全民的医疗保障制度，完善城镇职工基本医疗保险制度和新型农村合作医疗制度，并加强社区卫生服务机构的建设，提高卫生服务公平性和居民的健康水平。

Analysis of health services utilization in different groups of medical care assurance in Nanjing

Objective： Analyze the features of health services utilization in different groups of medical care assurance, in order to provide evidence for decision-making to improve the medical insurance system. Methods： Using a multi-stage stratified random sampling method, the 4 873 Nanjing residents inquired. Results： The existing medical security system played a significant role of the residents in the residential services utilization, but the affect was not obvious on use of out-patient services. As the guide of residents to medica treatment, the performance of city basic medical insurance was less important than new-type rural cooperative medical system. Conclusion： Government should speed up the establishment of universal coverage of medical security system, perfect the basic medical insurance system and the new rural cooperative medical system, strengthen community health services building, and also raise the equity of health services and the level of the health of the residents.