基于安德森模型的天津市居民中医药服务首诊意愿影响因素分析

Influencing Factors of Residents'Willingness of First-visit of Traditional Chinese Medicine Service in Tianjin Based on Andersen's Behavioral Model

目的:基于安德森模型,研究居民中医药服务首诊意愿的影响因素,为完善我国中医药政策提供参考。方法:采用多阶段抽样法在天津市抽取700名居民进行问卷调查,将改进后的安德森模型的各维度变量纳入二分类logistic回归模型,探讨居民中医药服务首诊意愿的影响因素。结果:共得到652份有效问卷,289人有中医药服务首诊意愿,占比44.74%。Logistic回归结果显示年龄、受教育程度、接触中医药宣传情况、“国医堂”受益程度、是否每年体检、自感健康状况和中医就诊效果满意度对居民中医药服务首诊意愿有显著影响。结论:天津市居民中医药服务首诊意愿相对较高。建议有关部门创新中医药宣传方式,出台政策提高中医药报销比例、扩大报销范围、优化报销流程,从软、硬件两方面提升基层中医药服务水平,助力分级诊疗政策的实施。

Objective:To study the influencing factors of residents'willingness of first-visit of TCM(Traditional Chinese Medicine)services based on the Andersen's behavioral model,so as to provide reference for perfecting the policy of TCM.Methods:Using multistage sampling method,700 residents in Tianjin were selected for a questionnaire survey.The dimensional variables of the improved Andersen's behavioral model were incorporated into the binary logistic regression model to explore the influencing factors of residents'willingness of first-visit of TCM services.Results:A total of 652 valid questionnaires were obtained,289 people had the willingness of first-visit of TCM services,accounting for 44.74%.The results of logistic regression showed that age,education level,exposure to TCM propaganda,benefit degree of“TCM Hall”,annual physical examination,perceived health status and satisfaction of TCM treatment effect had significant influence on residents'willingness of first-visit of TCM services.Conclusion:The willingness of residents'first-visit of TCM services is relatively high in Tianjin.It is suggested that relevant departments should innovate the propaganda methods of TCM,introduce policies to increase the proportion of reimbursement for TCM,expand the scope of reimbursement,and optimize the reimbursement process.Furthermore,relevant departments should improve TCM services at the grassroots level from two aspects of software and hardware,in order to help the implementation of hierarchical medical system.