基于混合Logit模型的我国农村居民就医选择的影响因素分析

Analysis on the influencing factors of Chinese rural residents choice of medical treatment based on mixed Logit model

[目的]了解我国农村居民在患病时就医机构选择的情况及其影响因素,为进一步提高居民卫生资源的利用率提供参考依据。[方法]基于2018年“中国家庭追踪调查”(CFPS)的调查数据,采用离散选择模型中混合Logit模型对我国农村居民医疗服务利用情况及其影响因素进行分析。[结果]回归结果显示,年龄越大、文化程度越高、居民支付能力越强、健康状况越差的居民更倾向于选择到大医院就诊(P<0.05)。在同等条件下,居民往往会选择到价格水平较低、医疗质量较高的机构就医(P<0.05)。[结论]年龄、婚姻状况、学历等社会人口学因素均会对我国农村居民就医机构的选择产生显著影响,居民的支付水平、健康状况、医疗服务价格与质量同样是影响患者选择就医机构的重要因素,医保对引导患者合理就医的作用仍不够明显,诊所在我国基层医疗服务中发挥着重要作用。

Objective In order to provide reference for further improving the utilization rate of residents health resources,this paper aims to understand the situation of rural residents choice of medical institutions when they are sick and its influencing factors.Methods Based on the data of“Chinese Family Panel Studies(CFPS)”,the mixed Logit in discrete choice model was used to analyze medical services utilization of rural residents and the influencing factors.Results Regression results showed that residents with older age,higher education level,higher payment ability and worse health status tended to choose big hospitals(P<0.05).Under the same condition,residents tended to choose institutions with lower price and higher medical quality(P<0.05).Conclusions Age,marital status,education background and other social demographic factors will have a significant impact on residents choice of medical institutions;Residents payment level,health status,price and quality of medical services are also important factors affecting patients choice of medical institutions.