[1]李 博,苗春霞,黄晓静,等.社会经济地位与居民基层首诊选择: 质量、性价比和可及性[J].卫生经济研究,2023,40(10):16-19.
 LI Bo,MIAO Chunxia,HUANG Xiaojing,et al.Socio-economic Status and Residents' Choice of First-visit at Primary Care Institutions: Quality, Cost Performance and Accessibility[J].Journal Press of Health Economics Research,2023,40(10):16-19.
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社会经济地位与居民基层首诊选择: 质量、性价比和可及性

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
40
期数:
2023年10期
页码:
16-19
栏目:
卫生服务需求
出版日期:
2023-09-28

文章信息/Info

Title:
Socio-economic Status and Residents' Choice of First-visit at Primary Care Institutions: Quality, Cost Performance and Accessibility
作者:
李 博1苗春霞1黄晓静1方 欣1尹娅妮1高修银2卓 朗2
1.徐州医科大学管理学院,江苏 徐州 221004
2.徐州医科大学公共卫生学院,江苏 徐州 221004
Author(s):
LI Bo MIAO Chunxia HUANG Xiaojing FANG Xin YIN Yani GAO Xiuyin ZHUO Lang
School of Management, Xuzhou Medical University, Xuzhou Jiangsu 221004, China
关键词:
基层首诊社会经济地位影响因素
Keywords:
first-visit at primary care institutions socio-economic status influencing factors
分类号:
R19
文献标志码:
A
摘要:
目的:基于社会经济地位异质性视角,探究居民首诊选择的影响因素,推动基层首诊精准落实。方法:采用自行设计的问卷,依据文化程度、职业、收入划分社会经济地位,利用χ2检验和Logistic回归探究居民基层首诊的影响因素。结果:居民患病就医率为41.45%,高、中、低社会经济地位居民基层首诊率分别为28.83%、47.66%、62.95%,居民患病就医率、基层首诊率随社会经济地位上升而下降。结论:居民就医率、基层首诊率及其影响因素存在异质性,质量、性价比、成本和可及性分别为高、中、低社会经济地位居民基层首诊的关注点,对此应差异化施策,以提升基层首诊率。
Abstract:
Objective To explore the influencing factors of residents' choice of first-visit at primary care institutions based on the perspective of heterogeneity in socio-economic status, and to promote the precise implementation of first-visit at primary care institutions. Methods Using a self-designed questionnaire, dividing socio-economic status based on education level, occupation, and income, the influencing factors of residents' first-visit at primary care institutions were explored by chi-square test and logistic regression. Results The medical treatment rate for residents was 41.45%. The first-visit rate at primary care institutions for residents with high, medium, and low socio-economic status were 28.83%, 47.66%, and 62.95%, respectively. The medical treatment rate and the first-visit rate at primary care institutions for residents decreased with the rise of socio-economic status. Conclusion There is heterogeneity in terms of medical treatment rate and the first-visit rate at primary care institutions for residents and their influencing factors. Quality, cost performance, cost and accessibility are the focus of residents with high, medium, and low socio-economic status, respectively. In this regard, differentiated policies should be implemented to improve the first-visit rate at primary care institutions.

参考文献/References:

[1] 张兴祥,陈申荣.我国分级诊疗改革政策实施效果的量化评估——以试点城市厦门为例[J].福建论坛(人文社会科学版),2019(2):192-204.
[2] 李华,徐英奇.分级诊疗对居民健康的影响——以基层首诊为核心的实证检验[J].社会科学辑刊,2020(4):122-134.
[3] 林建鹏,祝子翀.我国基层医疗服务居民获得感与首诊状况调查[J].医学与社会,2022,35(9):10-14,25.
[4] 安然,秦立建,杨晓胜,等.广东省城乡居民基本医疗保险参保者基层首诊意愿的影响因素分析[J].医学与社会,2022,35(11):61-65.
[5] 钱锡红,刘佳,戴源源.广州市居民分级诊疗认知与就医行为研究[J].卫生经济研究,2022,39(3):53-55,59.
[6] 赵锐,付强.网格化管理布局下紧密型医疗联合体内患者基层首诊现况调查[J].中国医院管理,2022,42(10):31-33,38.
[7] 宋海燕,叶小琴,甄诚,等.北京市医联体内患者基层首诊意愿及其影响因素研究[J].中国卫生政策研究,2018,11(2):30-36.
[8] 汪曾子,刘娅莉,蒋祎,等.医疗机构患者政策认知对基层首诊意愿的影响分析[J].卫生经济研究,2019,36(6):24-27,31.
[9] 王丽君,鲁志鸿,李友卫,等.山东省城乡居民基层医疗机构首诊和转诊意愿及其影响因素分析[J].中国公共卫生,2021,37(3):465-469.
[10] Shavers Vickie L.Measurement of socioeconomic status in health disparities research[J].Journal of the National Medical Association,2007,99(9):1013-1023.
[11] 王奎明.中产阶层的公共参与度更高吗?——基于社区层面的比较研究[J].探索,2022(5):152-164.
[12] 李倩莹,刘方,黎志华.主观社会经济地位对成年早期幸福感的影响:一个链式中介模型[J].中国临床心理学杂志,2022,30(4):802-807.
[13] 李其容,李春萱.创业市场信心与创业行为关系的动态解析——基于GEM与WBD的混合横截面数据的经验证据[J].技术经济,2022,41(10):79-93.
[14] Kraus Michael W,Piff Paul K,Mendoza-Denton Rodolfo,et al.Social class,solipsism,and contextualism:how the rich are different from the poor[J].Psychological review,2012,119(3):546-572.
[15] 朱光磊,王通.阶层与分层:中国社会成员构成研究中的两种分析逻辑[J].吉林大学社会学学报,2020,60(6):13-23,231.
[16] 李强.试析社会分层的十种标准[J].学海,2006(4):40-46.
[17] 吴炳义,董惠玲,于奇,等.中国老年人口健康预期寿命的社会分层分析[J].人口与发展,2021,27(5):2-11.
[18] 吴素雄,俞林伟,熊晶晶.医联体模式下浙江农村居民的首诊偏好与政策选择[J].成都行政学院学报,2019,122(2):64-71.
[19] 侍书靖,苗春霞,黄畅,等.基于Shapley值法的我国居民就医机构选择及影响因素研究[J].中国卫生事业管理,2022,39(7):509-512,526.
[20] Li Xuefeng,Deng Li,Yang Han,et al.Effect of socioeconomic status on the healthcare-seeking behavior of migrant workers in China[J].PloS one,2020,15(8):e0237867.
[21] 郭未,鲁佳莹,刘林平.流动时代的健康中国:社会经济地位、健康素养与健康结果[J].人口学刊,2022,44(2):1-18.
[22] 孙晶晶,董舞艺,崔牛牛,等.中国已经发生健康贫困的女性化了吗?——基于“全国健康扶贫动态监测系统数据”的研究[J].人口与发展,2022,28(4):75-90.

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更新日期/Last Update: 2023-09-28