我国城市居民自我医疗利用的影响因素研究

Study on the determinants of self-treatment utilization by the urban residents in China

目的:分析我国城市居民自我医疗利用的影响因素,增进对国内城市居民自我医疗需求行为的认知和理解。方法:根据第四次国家卫生服务调查的有关数据,采用二项logistic回归模型分析。结果:根据模型估计结果,家庭人口数、年龄、保险状况、平均消费水平、疾病类型、就医距离等是影响城市居民自我医疗利用的主要因素。结论与建议:扩大城市居民医疗保险的覆盖面,完善相应的就医引导制度,提高低收入患者对正式医疗服务的经济可及性;合理规划设置城市医疗机构布局,提高患者就医的距离可及性;加强对慢性病患者的自我医疗知识教育,进一步开展有关患者就医观念等对自我医疗利用的影响及相应费用与效果方面的研究。

Objective： This article is to identify the determinants of utilization of self-treatment by patients in urban areas,and to promote deep understanding of self-treatment demand behavior.Methods： Binary Logistic Regression model is used,the data came from the fourth China National Health Services Survey（NHSS）.Results： The result from the estimated model suggests that family size,age,status of health insurances,level of average consumption,type of illness and distance are statistically significant determinants of patients＇ utilization of self-treatment.Conclusions and recommendations： health insurance coverage in urban residents should be expanded and corresponding health service utilization regulations should be perfected;government should implement special medical aid scheme or establish aid fund to improve poor patients＇ access to formal treatment;the geography of health institutions in urban areas should be made reasonably to improve patients＇ access to formal treatment in the aspect of geographic distance;related knowledge and education on self-treatment should be given to patients that often utilize self-treatment,researches on the effect of some factors on self-treatment utilization,such as health seeking conception,and the cost and effectiveness of self-treatment have been put forward to further study in the future.