轻度慢性病假设下武汉市城乡居民就医偏好分析

Urban and Rural Residents'Preferences for Medical Treatment in Wuhan Under the Assumption of Mild Chronic Disease

目的:分析城乡居民在轻度慢性病假设下就医方式的选择偏好及支付意愿,了解城乡居民医疗卫生服务需求,为进一步实施和完善分级诊疗制度提供建议。方法:对武汉市城区、郊区680名城乡居民进行问卷调查。通过描述性分析和混合logit模型的构建与计算,分析城乡居民就医方式选择的偏好主效应和支付意愿。结果:城乡居民倾向选择西医、距离近和费用低的就医方式。为了获得西医服务,城乡居民分别愿意多自付135.38和124.91元。分别需要补贴51.3和112.48元才能让城乡居民放弃选择距离近的就医方式。结论:城乡居民就医方式的选择偏好与分级诊疗的目标具有一致性。城乡居民倾向选择西医,对中医药总体认同度不高。相对于城市居民,农村居民更不倾向距离远的就医方式。建议发挥中医药优势,引导医疗卫生服务资源下沉,加快农村基层卫生机构的空间与数量布局建设。

Objective:To analyze the selection preference and payment willingness of urban and rural residents under the assumption of mild chronic disease,to understand the medical and health service demands of urban and rural residents,to provide suggestions for further implementation and improvement of the hierarchical medical system.Methods:A questionnaire survey was conducted among 680 urban and suburban residents in Wuhan city.Through descriptive analysis and the construction and calculation of mixed logit model,the main effect of preference and willingness to pay for medical treatment choice of urban and rural residents were analyzed.Results:Residents tended to choose medical treatment with western medicine,nearer distance and lower cost.Urban and rural residents were willing to pay more than 135.38 and 124.91 yuan respectively for receiving western medicine service.It was necessary to subsidize 51.3 and 112.48 yuan respectively to enable urban and rural residents to give up choosing nearer medical treatment.Conclusion:Urban and rural residents'preferences for medical treatment is consistent with the goal of hierarchical medical system.Moreover,they are inclined to choose medical treatment with western medicine,the overall degree of recognition of traditional Chinese medicine is not high.Compared with urban residents,rural residents are less inclined to seek medical treatment with far distance.It is suggested to give full play to the advantages of traditional Chinese medicine,guide medical and health service resources to sink,and accelerate the construction of space and quantity distribution of rural grassroots health institutions.