我国城市居民就医选择行为及其影响因素分析——以五城市为例

Analysis of the factors affecting individuals' hospital choice for medical consultation in urban China-a case study of five cities

我国医疗服务市场存在着未被满足的需求和过剩的供给能力,本世纪初以来,随着城市居民收入的提高和政府大力推行的医疗保险,城市居民对医疗服务产生更大的需求。本文利用沈阳等五个城市入户调查的数据,采用多元logit模型考察了城市居民就医选择以及影响这一行为的重要因素。从计量回归的结果可以看出,显著影响居民就医选择的因素有医疗保险状况、收入状况、健康状况、社会人口学因素等。在总结研究的基础上,提出建议:促进社区卫生服务机构等基础医疗机构发展,合理引导就医选择流向;注重基础医疗机构的服务质量;县级医院可尝试转型,提高效率。

Objective： There exists an unsatisfied demand for hospital specialist services and excessive supply of clinic and district hospital services simultaneously in urban China’s market for hospital care services.Since the beginning of this century,the government has initiated a health insurance system for the population in the urban areas and has made a noticeable progress in expanding the coverage.With rising income and insurance coverage,the question about the type of hospital service to be selected has become an important issue for the urban population.The paper uses the household data of five cities in China to study the determinants affecting individuals’ hospital choice for medical consultation.The study uses multinomial logit model and researches insurance coverage,income,self-assessed health status,education and city dummy variables affecting the individuals’ hospital choice for medical consultation in urban China.The countermeasures have been put forward,including the promotion of community health service institutions and other basic medical institutions development,the reasonable guidance hospital choice of flow,improvement of medical service quality and the trial of the transformation of the county hospitals for the improvement of efficiency.