新医改十年宁夏回族自治区农村居民健康状况与卫生服务利用公平性的进展与成效

Background? The health care and health system reform is a worldwide issue. In 2009China launched a new round of health care and health system reform. Over the past ten yearsespecially since the 18th National Congress of the Communist Party of Chinathe reform has brought tangible benefits to nearly 1.4 billion people. The decade of the new medical reformwhich concentrates the interests of all partiesis a highlight of China's medical and health services. The discussion and demonstration of the reform effectiveness has become a hot topic in the academic field. Objective ?To sort out and analyze the data changes of the health status and equity of health service utilization of rural residents in Ningxia Hui Autonomous Region during the process of new medical reform and the reflected development effectiveness. Methods ?The baseline data was collected from the "Family Health Interview Survey for Rural Residents" in Ningxia Hui Autonomous Region in 2009and the follow-up data in 2015 and 2019. The self-rated unhealthy rate and prevalence of chronic diseases were selected as indicators to measure the health status of residentsand the two-week consultation rate and hospitalization rate were selected as indicators to measure the health service utilization of residents. The concentration indexCI and its decomposition method were used explore the health status and equity of health service utilization of rural residents in Ningxia Hui Autonomous Region in the past decade of the new medical reform. Results ?During the decade of the new medical reformthe self-rated unhealthy rate of rural residents in Ningxia Hui Autonomous Region decreasedand the prevalence of chronic diseases increased year by year. The self-rated unhealthy rate in 20092015 and 2019 was 20.37%4 107/20 16017.75%3 216/18 114 and 19.51%3 527/18 074the prevalence of chronic diseases was 13.01%2 623/20 16019.45%3 523/18 114 and 26.28%4 750/18 074respectively. The overall changes in health service utilization showed an upward trendthe two-week consultation rate in 20092015 and 2019 was 6.43%1 296/20 1605.66%1 026/18 114 and 8.06%1 457/18 074the hospitalization rate was 8.89%1 792/20 16010.66%1 931/18 114 and 13.23%2 392/18 074respectively. Equity of health and health service utilization have been improvedthe CI of the self-rated unhealthy rate of rural residents in Ningxia Hui Autonomous Region in 20092015 and 2019 was -0.024 1-0.095 2 and -0.098 0the CI of the prevalence of chronic diseases in 20092015 and 2019 was -0.001 3-0.081 5 and -0.081 0respectivelythe CI of two-week consultation rate was 0.068 8-0.011 3-0.051 2and the CI of two-week hospitalization rate was 0.039 0-0.029 4-0.061 2respectively. The main influencing factors of equity gradually evolved from the relatively single phenomenon of economic income being the dominant factor to the situation where ageeconomic incomechronic diseaseseducation level and other factors interact in multiple ways. Conclusion ?The health status and equity of health service utilization of rural residents in Ningxia Hui Autonomous Region has been improved in the past decade of the new medical reform. Howevermore attention should be paid to new issues and inequities caused by the aging population and changes in social structure.