基于AdaBoost算法的珠三角地区中老年慢性病患者就诊机构选择及其影响因素

Choice of Medical Institutions and Its Influencing Factors for Middle-aged and Elderly Patients with Chronic Diseases in the Pearl River Delta Region Based on Adaboost Model

目的:了解珠三角地区中老年慢性病患者就诊机构的选择状况,探讨影响其就诊决策的因素,为推进分级诊疗提供依据。方法:于2018-2019年在珠三角地区开展慢性病防控调研项目,根据研究需要筛选出2663名中老年慢性病患者,了解其过去1年就诊情况,使用AdaBoost算法进行影响因素分析。结果:2663名患者中,过去1年内多就诊于基层医疗机构的占75.14%。AdaBoost算法分析结果显示各影响因素相对重要性排名前3的分别是离家最近的医疗机构类型、从家步行至最近的基层医疗机构所需时间及受教育程度。结论:珠三角地区中老年慢性病患者的基层卫生服务利用率有待提高,需继续加大基层医疗机构的建设,加强分级诊疗制度的宣传,发挥基层医疗机构慢性病防控的重要作用。

Objective:To understand the situation of the choice of medical institutions for middle-aged and elderly patients with chronic diseases in the Pearl River Delta Region,and to explore the factors affecting their decision-making,so as to provide the basis for promoting hierarchical medical care.Methods:The research project on chronic diseases prevention and control was carried out in the Pearl River Delta Region from 2018 to 2019.According to the research needs,2663 middle-aged and elderly patients with chronic diseases were selected to understand their medical treatment in the past year.AdaBoost model was used to explore the influencing factors.Results:Among the 2663 patients,75.14%of them chose grassroots medical institutions most often for treatment in the last year.The AdaBoost model analysis results showed that type of medical facility closest to home,the time required to walk from home to the nearest grassroots medical institutions,and educational level were the three highest rank variables of all variables sorted according to the relative importance.Conclusion:The utilization rate of grassroots medical institutions for middle-aged and elderly patients with chronic diseases in the Pearl River Delta Region needs to be improved.It is necessary to continue to increase the construction of grassroots medical institutions and strengthen the publicity of hierarchical medical system,so as to make the role of prevention and control of chronic diseases in grassroots medical institutions better play.