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目的:分析新疆生产建设兵团城镇职工基本医疗保险参保人口医疗服务利用的变化情况,为进一步发展和完善兵团城镇职工基本医疗保险提供依据。方法:利用兵团2004年和2010年两次卫生服务调查资料,对参保人口的卫生服务需要、卫生服务利用和医疗费用变化进行分析。结果:2004年与2010年相比,参保职工两周患病率由211.8‰上升到390.2‰,两周就诊率由81.6‰上升至95.0‰,年住院率由106.9‰上升至145.9‰,未住院率由19.4%下降到14.1%,经济困难是未利用住院服务的主要原因,次均就诊费用年增长率为4.1%,次均住院费用年增长率为5.7%。结论:兵团城镇职工基本医疗保险制度一定程度地促进了职工对门诊及住院医疗服务的利用,但医疗费用增长较快,补偿水平不高,尚不能完全保障职工合理的医疗服务需求。
OBJECTIVE: To analyze the changes of the medical service utilization of the basic medical insurance for urban workers in Xinjiang Production and Construction Corps, and provide the basis for further developing and improving the basic medical insurance for the urban workers in the Corps. Methods: Based on the Corps’ health service survey data from 2004 and 2010, the health service needs of insured population, the utilization of health services and the changes of medical expenses were analyzed. Results: Compared with 2010, the prevalence of insured workers in two weeks rose from 211.8 ‰ to 390.2 ‰, the two-week visiting rate rose from 81.6 ‰ to 95.0 ‰, and the annual hospitalization rate rose from 106.9 ‰ to 145.9 ‰. The hospitalization rate dropped from 19.4% to 14.1%. Economic difficulties were the main reason for unused hospitalization services. The average annual cost of visiting medical services was 4.1% and the average annual cost of hospitalization was 5.7%. Conclusion: The BMI basic medical insurance for urban workers promoted the utilization of outpatient and inpatient medical services to a certain extent. However, the medical expenses increased rapidly and the compensation level was not high enough to fully guarantee the reasonable medical service needs of workers.