基层首诊影响居民健康的实证检验——来自湖南居民健康自评数据的证据

Study on the influence of primary diagnosis on the health status of residents:Based on self-health-assessment data of Hunan residents

为了评估基层首诊在促进居民健康方面的作用,利用湖南省居民体检自评数据,实证分析了基层首诊对居民健康的影响,并利用GMM方法进行了稳健性分析。结果显示:基层首诊对居民健康自评的影响显著为正;年龄越大越不倾向于选择基层首诊;女性比男性更倾向于选择基层首诊;已婚人士往往比未婚、离婚、丧偶、分居人士更倾向于使用基层首诊;过去四周的患病情况会在一定程度上影响居民对基层首诊的选择;高学历的人们更加倾向于选择基层首诊;城市居民更倾向于使用基层首诊,乡村居民对基层首诊使用较少;城镇化指数越高、人口密度越大、社区卫生条件更好的地区,居民更倾向于选择基层首诊。异质性分析结果显示,人均GDP越高的城市,基层首诊对健康自评的影响越有正向促进作用。

In order to evaluate the role of primary diagnosis in promoting residents’health,this paper empirically analyzes the impact of primary first visit on residents’health by using the self-assessment data of residents’physical examination in Hunan province,and makes a robust analysis by using GMM method.The results are as follows:the influence of primary diagnosis on residents’health self-assessment is significantly positive;the older the people are,the less likely they are to choose the primary first visit;women are more likely to choose primary first visit than men;married people tend to use primary first visit more than those who are unmarried,divorced,widowed or separated;the prevalence of diseases in the past four weeks affects residents'choice of primary diagnosis to a certain extent;people with higher education are more inclined to choose primary treatment;urban residents prefer to use primary treatment,while rural residents use less;residents in areas with higher urbanization index,higher population density and better community health conditions are more likely to choose primary treatment diagnosis.The results of heterogeneity analysis show that the higher the per capita GDP of the city,the more positive the impact of the first visit on health self-assessment.