分级诊疗背景下数字素养对我国中老年患者就医机构选择的影响研究

Study on Impact of Digital Literacy on Selection of Healthcare Institutions for Middle-aged and Elderly Patients in China Under the Background of Hierarchical Medical Care

目的:探讨数字素养对我国中老年患者就医机构选择的影响,为丰富分级诊疗激励路径提供参考。方法:基于2020年中国家庭追踪调查数据,纳入45岁及以上中老年患者11151人,采用分层logistic回归模型和倾向值匹配等方法分析中老年患者数字素养对其就医机构选择的影响。结果:我国中老年患者的基层就诊率为59.53%。在控制其他影响因素后,与较低数字素养的中老年患者相比,高数字素养的中老年患者更倾向于选择到医院就诊(β=-0.200,P<0.001)。与患单种慢性病的中老年人相比,患有共病的中老年人更倾向于选择到医院就诊(β=-0.256,P<0.001)。结论:中老年患者数字素养影响其就医机构选择,数字素养越高,其前往医院就诊的倾向越明显;中老年患者的慢性病患病情况越严重,越倾向于选择到医院就诊。未来的分级诊疗宣传应在区分中老年人不同数字素养和慢性病患病情况的基础上,针对性地设计宣传方案和制定分级诊疗政策,提升分级诊疗激励效果。

Objective:To explore the impact of digital literacy of middle-aged and elderly patients on the selection of healthcare institutions,so as to provide references for enriching the incentive path of hierarchical medical care.Methods:Based on the 2020 China family panel studies data,11151 middle-aged and elderly patients aged 45 and above were included.The impact of digital literacy on the choice of healthcare institutions for middle-aged and elderly patients was analyzed using hierarchical logistic regression models and propensity value matching methods.Results:The grassroots consultation rate of middle-aged and elderly people in China is 59.53%.After controlling for other influencing factors,compared with middle-aged and elderly people with lower digital literacy,middle-aged and elderly people with higher digital literacy are more likely to choose to seek medical treatment in hospitals(β=-0.200,P<0.001).Compared to middle-aged and elderly people with a single chronic disease,middle-aged and elderly people with comorbidities are more likely to choose to seek medical treatment in hospitals(β=-0.256,P<0.001).Conclusion:The digital literacy of middle-aged and elderly patients affects the selection of healthcare institutions.The higher the digital literacy of middle-aged and elderly patients,the more inclined they are to seek medical treatment in hospitals.The more severe the chronic disease situation of middle-aged and elderly patients,the more inclined they are to seek medical treatment in hospitals.The future promotion of hierarchical medical care should be based on distinguishing the different digital literacy and chronic disease conditions of middle-aged and elderly people,designing targeted promotion plans and formulating hierarchical medical care policies,thus enhancing the hierarchical medical care incentive effect.