基于离散选择实验的互联网医院诊疗服务偏好研究

Research on medical service preference of Internet hospital based on discrete choice experiment

[目的]分析居民对互联网医院诊疗服务的偏好,为互联网医院的可持续发展提供参考。[方法]基于离散选择实验方法,以429名居民为调查对象,利用查阅文献、专家咨询的方法确定运营主体、医生推荐指数、就诊方式和服务费用4个属性,采用正交试验设计确定4个选择集和1个“质量控制”选择集。采用网上问卷调查的方式进行数据收集,对得到后的数据进行条件Logit回归分析。[结果]相对于I型的运营主体,居民更愿意H+I型的运营主体(β=0.379),选择H+I型是选择I型的1.461倍(P<0.01);相对于低的医生推荐指数,居民更愿意选择中(β=1.131)、高(β=0.861)医生推荐指数,选择中、高医生推荐指数分别是选择低的医生推荐指数的3.098倍、2.366倍(P<0.01);相对于以图文的问诊方式,居民更愿意选择电话的问诊方式(β=0.539),而不愿意选择视频的问诊方式(β=-0.499),选择电话是选择图文的1.715倍(P<0.01),选择视频是选择图文的0.607倍(P<0.01)。[结论]医生推荐指数是居民选择互联网医院诊疗最看重的属性。建议加强互联网医院人才队伍建设,提高其技术水平和能力;强化互联网医院监管,保障居民隐私安全。

Objective To analyze the residents’ preference for Internet hospital medical services and provide reference for the sustainable development of Internet hospital. Methods Based on the discrete choice experiment method,429 residents were selected as the survey objects.The four attributes of operation subject,doctor recommendation index,treatment mode and service cost were determined by consulting literature and consulting experts. Four selection sets and one“quality control”selection set were determined by orthogonal experimental design. The data were collected by means of online questionnaire,and the obtained data were analyzed by conditional logit regression. Results Compared with type I operators,residents preferred type H + I operators( β = 0. 379),which was 1. 461 times higher than type I operators( P < 0. 01).Compared with low doctor recommendation index,residents were more willing to have medium( β = 1. 131) and high( β = 0. 861) doctor recommendation index. The doctor recommendation index of medium and high selection were 3. 098 times and 2. 366 times of than of low selection respectively( P < 0. 01). Residents were more likely to choose telephone consultation( β = 0. 539) than video consultation( β =-0. 499),choosing telephone was 1. 715 times more than choosing text( P < 0. 01),and choosing video was 0. 607 times more than choosing text( P < 0. 01). Conclusions Doctor recommendation index is the most important attribute for residents to choose Internet hospitals. It is suggested to strengthen Internet construction of talent team and improve its technical level and ability;Strengthen supervision of Internet hospital so as to protect residents’ privacy and security.