中国城市居民医疗服务利用影响因素的研究——四步模型法的基本理论及其应用

Research on the Determinants of Medical Care Utilization by Urban Population in China:the Principle of Four-part Model and its Application.

目的 对中国城市居民医疗服务利用的影响因素进行了分析。方法 采用四步模型法对医疗服务利用进行研究。结果 影响城市就诊和住院概率的因素主要是疾病种类及其严重程度、儿童少年和医疗保障制度 ,未见社会经济、卫生服务可及性等因素的显著性差异 ;医疗服务利用差异突出反映在不同阶层居民在门诊和住院过程中的资源消耗 ,高阶层居民医疗费用明显高于低阶层可通过不同的医疗服务质量和诱导需求加以解释。结论 中国城市居民医疗保障制度的改革势在必行 ,要注重费用控制 。

Objective to examine the determinants of medical care utilization by urban China.The paper introduced the principle of four-part model and its application in health services research.Methods The four-part model is applied to study the determinants of medical care utilization.Results The results shown that major factors influencing the probability of outpatient and inpatient care in urban China were category and severity of disease,age and health insurance.There were significant differences in the amount of medical resource consumption among different socioeconmoic classes and the people with higher socioeconomic group had greater medical expenditure than those of low group.Conclusion As indicated by this study,China needs to pay much more attention to health insurance reform in urban areas.