中国农村居民的就诊选择研究——来自甘肃、河南、广东三省农户调查的实证分析  

Individuals' First Health Care Choice in Rural China: Empirical Study Based on the Survey of Gansu,Henan and Guangdong Province

作　　者：孙梦洁[1] 韩华为[2] 

机构地区：[1]北京大学经济学院 [2]北京师范大学社会发展与公共政策学院

出　　处：《经济评论》2013年第2期40-50,111,共12页Economic Review

基　　金：北京大学经济与人类发展研究中心刘民权教授主持的加拿大国际发展研究中心(IDRC)项目"中国农村卫生人力资源研究--现状评估与预测"(项目编号:105008-001);中国博士后基金面上资助项目"中国农村居民的寻医行为研究"(项目编号:2011M600161)的资助

摘　　要：基于甘肃、河南、广东三省18个县的实地调查数据,本文分别采用多项Logit模型(MNL)、条件多项Logit模型(CLM)和嵌套多项Logit模型(NLM)对中国农村患者初次就诊选择与就医机构选择进行了实证分析。实证结果发现,支付水平仍然是制约农村患者尤其是低收入群体选择正规医疗服务的重要因素。对于患有慢性及传染性疾病以及自评健康状况较差的农户而言,医疗可及性是另一影响其就诊的重要因素。对于贫困患者而言,收入水平、疾病严重程度及自评健康水平对其就医选择的影响与非贫困农户存在显著差异。This paper executes an empirical study of individuals＇ first health care choice and medical facility choice in rural China. The paper applies Muhinomial Logit Model,Conditional Muhinomial Logit Model and Nested Muhinomial Logit Model based on the data from three provinces of Gansu, Henan and Guangdong, including 18 counties. Through the econometric analysis,we find that the ability to afford the pay is still the significant factor to affect the patients＇ formal health care choice especially for low - income groups. For the individuals who have chronic diseases, infectious diseases or bad selfrated health in rural China, medical accessibility is another significantly factor for their first health care choice. The results show that the influence of income level, symptoms severity and self - rated health on choice of medical treatment is significanly different between poverty and un - poverty groups in rural China.

关 键 词：医疗需求行为 初次就诊 就诊机构 贫困农户 

分 类 号：F203[经济管理—国民经济] R195[医药卫生—卫生统计学]