分级诊疗制度下居民选择就诊医疗机构的影响因素研究

Influencing factors forresidents’ choice of healthinstitutions under the hierarchical diagnosis andtreatment system

目的在分级诊疗制度下,了解居民就诊医疗机构选择现状及其影响因素,为促进居民合理就诊和完善分级诊疗制度提供建议。方法以2018年全国家庭追踪调查数据为基础,从人口学特征、经济水平、医疗保障、健康水平、医疗服务5个维度出发,通过logit回归探究影响居民就诊医疗机构选择的因素。结果人口学特征中城乡、年龄、婚姻状况、受教育程度,经济水平中家庭人均年纯收入、家庭医疗支出,医疗保障中有无医疗保险和部分医疗保险类型,健康水平中慢性病、身体状况,医疗服务中看病点的医疗水平和看病点的医疗满意度是居民就诊医疗机构选择的影响因素。结论提升基层医疗服务质量,增强居民就医满意度;完善医疗保险报销政策,形成良好的就医习惯;加大政策宣传和推广力度,培养正确的就医观;提高居民健康素养,注重个人健康管理。

Objective To know about the status quo and influencing factors of residents’ choice of health institutions under the hierarchical diagnosis and treatment system, and to provide suggestions for promoting residents’ rational medical consultation and improving the hierarchical diagnosis and treatment system. Methods Based on the data of 2018 China Family Panel Studies, from five dimensions, namely demographic characteristics, economic level, medical security, health status and health services, Logit regression was used to explore factors influencing residents’ choice of health institutions. Results The influencing factors for residents’ choice of health institutions were the following ones of the demographic characteristics: urban or rural areas, age, marital status, education level, per capita annual net income of a family, family health spending, participation in medical insurance or not, participation in some types of medical insurance, chronic diseases, health status, treatment level of health care and residents’ satisfaction with treatment. Conclusions It is necessary to improve the quality of primary medical services and increase residents’ satisfaction with medical treatment, to improve medical insurance reimbursement policies and help residents develop good habits of medical consultation, toenhance policy publicity and promotion to cultivate a correct view of medical consultation, and to improve residents’ health literacy and focus on personal health management.