年龄分层视角下医疗设施可达性对居民就医行为的影响——以上海市崇明岛为例

THE INFLUENCE OF MEDICAL FACILITY ACCESSIBILITY ON RESIDENTS’ HEALTH SEEKING BEHAVIORS FROM THE PERSPECTIVE OF AGE STRATIFICATION:A CASE STUDY OF SHANGHAI CHONGMING ISLAND

年龄是影响就医行为的重要因素,从年龄分层视角出发探讨医疗资源可达性对就医行为的影响有助于理解居民的就医行为决策机理。本文以崇明岛为案例,利用一手调查数据,结合两步移动搜寻算法和回归分析方法,探讨了医疗设施可达性对居民就医机构选择和惯常就医距离的影响,揭示了不同年龄群体之间就医行为影响机理的差异。研究发现,医疗设施可达性对不同年龄群体就医行为的影响程度存在显著差异;可达性对老年人的就医行为影响尤为显著;中年人同时受到空间因素和社会经济属性的影响,且性别差异较为突出;青年人更倾向于前往高等级的医疗机构就医。研究为面向不同群体需求制定差异化的医疗资源配置策略以及引导居民的理性就医提供了依据。

From the perspective of space, discussing the impact of accessibility of medical resources on health seeking behavior is conducive to a better understanding of residents’ decision-making mechanism for health seeking behavior, and to explore the supply and demand relationship between health seeking behavior and medical resources. This study takes Chongming Island of Shanghai as a study case, using primary survey data to analyze the differences of health seeking behavior among different age groups from the perspective of age stratification. Combined with two-step floating catchment area method, this paper discusses the influence of the accessibility of medical facilities on the choice of medical institutions and habitual health seeking behavior distance of residents in Chongming Island, and the differences in the influence mechanism between different age groups are revealed. The study found that the medical facilities accessibility has a significant impact on residents’ health seeking behavior, and the impact on different age groups is significantly different. Accessibility has a particularly significant impact on the health seeking behavior of the elderly,middle-aged people are affected by spatial factors and socioeconomic attributes, and gender differences are more prominent.