户主视角下医疗资源可达性对就医行为的影响研究——以上海市郊区为例

The Impact of Medical Resource Accessibility on Health Seeking Behavior from the Perspective of Household:A Case Study of Shanghai Suburbs

公共服务设施均等化背景下,对就医行为影响机理进行研究有利于医疗资源的合理配置。不同群体的就医行为及影响因素存在差异,已有研究多关注不同性别、户籍人群的就医行为差异。而户主作为基本社会单元(家庭户)的负责人或权益代表人,往往拥有更高的家庭地位,医疗资源的获取能力在户主和非户主间可能存在差异。将空间视角与社会视角相结合,以就医倾向和就医距离为研究对象,分析户主视角下医疗资源可达性对居民就医行为的影响。利用上海市郊区居民活动日志调查数据,采用多元线性回归和二项logistics回归方法,探讨不同性别户主与非户主在就医行为上的差异及其影响因素,旨在为促进就医公平提供实证依据。研究发现:户主与非户主的就医倾向和就医距离存在显著不同,户主在患常见病后,更倾向于就医,且更倾向于近距离就医,其中女性户主比男性户主更注重就医的便利程度;医疗资源可达性对就医距离具有显著影响,医疗资源可达性越好,就医距离越短;交通可达性的改善有利于促进居民患常见病后主动就医,且能够缩短就医距离。由此可见,城市的交通可达性和医疗资源可达性对居民的就医行为产生显著影响。

Under the background of equalization of public service facilities,the study on the influence of medical seeking behaviors is conducive to the rational allocation of medical facilities.There are differences in medical seeking behaviors and influencing factors among different groups.Previous studies pay more attention to gender,household registration system and other groups'medical behavior differences.As the responsible person or rights representative of a household,the household head often has a higher family status,and the choices of medical facilities between the household head and household members may be different.This study combines the spatial perspective and social perspective,takes medical treatment tendency and medical choice as the research object,and analyzes the impact of medical resource accessibility on medical seeking behavior from the perspective of the household.Based on the first-hand survey data of Shanghai suburban residents'activity logs,the study uses multiple linear regression and binomial logistic regression methods to explore the differences and influencing factors between household head's and household members'medical seeking behaviors.The results show significant differences between the household head and household members.The household head tends to seek medical treatment in a closer distance,among which female household heads pay more attention to the convenience of medical treatment than males.Medical accessibility has a significant impact on the distance to seek medical treatment.The better the accessibility of medical resources,the shorter the distance.The improvement of traffic accessibility is conducive to promoting residents to actively seek medical treatment after suffering from common diseases,and can shorten the distance.Therefore,the accessibility of urban traffic and medical resources has a significant impact on residents'medical behavior.The study aims at providing an empirical basis for promoting medical equity.