中部地区居民就诊机构选择决策因素变化研究

Research on the Change of Strategies in Choosing Medical Institutions Among Residents in Central China

目的了解中部地区居民就诊机构选择的决策因素,分析各决策因素的变化趋势,为引导居民医疗服务合理利用提供依据。方法以县域居民为对象,采用多阶段分层随机抽样方法,选择安徽、河南、湖北3个县区开展问卷调查,描述性分析居民就诊选择及决策因素变化。结果技术水平、环境态度、便捷程度及费用水平4个指标在居民就诊机构选择决策中权重分别为0.320、0.299、0.229、0.222;技术水平权重随县级医院距离增加由0.319上升到0.328;居民属性不同,其就诊偏好不同,居民最重视技术水平,权重为0.338,住院患者最重视环境态度,权重为0.302。结论居民就诊机构选择决策因素的优先顺序为技术水平、费用水平、便捷程度、环境态度;年轻人易受医院环境态度的吸引,老年人偏好较近的医院;距医院越远,就诊时越看重技术水平;健康居民看重技术水平,家属看重费用及便捷度。

Objective To research the decision-making factors for the medical treatment selection of residents in the central China,and to provide the basis for guiding the reasonable utilization of residents＇ health service. Methods Investigation of residents and patients in three counties in Anhui,Henan and Hubei Provinces were done in the use of multi-stage stratified random sampling method. Results The four decision-making factors of technical level,condition and attitude,convenience,and cost level of medical institutions are 0.320,0.299,0.229 and 0.222 respectively in the selection decision of residents. The weight of technical level goes up from 0.319 to 0.328 with the increase of county hospital distance. Residents of different properties have different preferences on medical institutions. The residents attach the most importance to technical level,with a weight of 0.338. The inpatients were most concerned with condition and attitudes,with a weight of 0.302. Conclusion The priorities of decision-making factors for residents＇ medical treatment institutions are the technical level,cost level,convenience,conditions and attitudes. Young people are more susceptible to hospitals＇ conditions and attitudes while older people prefer closer one. The further away from medical institutions, the more attention will be paid to the technical level. Healthy residents value technical level most,relatives value cost and convenience.