我国城乡中老年群体基层就医的影响因素分析——基于CHARLS数据的实证研究  

Analysis on the influencing factors of primary health care choice in middle-aged and elderly population based on CHARLS data

作　　者：徐晓丹[1] 吴文强[2] 

机构地区：[1]厦门大学教育研究院,福建厦门361005 [2]福州大学经济与管理学院,福建福州350116

出　　处：《中国卫生政策研究》2016年第4期23-30,共8页Chinese Journal of Health Policy

基　　金：福建省社会科学研究项目(2012B021)

摘　　要：合理引导居民基层就医是落实社区首诊、推动建立双向转诊制度的关键。基于中国健康与养老追踪调查(CHARLS)数据,以城乡中老年群体的基层医疗消费选择为视角,利用Probit模型、工具变量法和分群体回归检验法,分析城乡中老年群体基层就诊、住院的现实影响因素,探讨制约中老年群体基层就医的客观条件。研究发现,城乡中老年群体的基层就医行为受个体特征、家庭特征、医疗机构特征、医疗支出、医疗保障等多维因素影响;结合实证分析与讨论,应通过加强教育宣传,发展基层医疗卫生机构能力,理顺医疗服务价格和加快基本医疗保险政策改革等措施引导城乡中老年群体的基层就医行为,进而推进我国"双诊制"建设。Properly guiding residents to choose the primary medical services is very important for establishing a dual referral system. Based on CHARLS data, an analysis for primary health care choice in the middle-aged and elderly residents is completed by using the Probit models, instrumental variables method and regression test in groups. The results show that individual and family characteristics, medical institutions, heahhcare expenses and medical insurances and other multi-dimensional factors significantly impact on the individuals＇ health care service choice. Based on the empirical analysis and discussion, the system should be strengthened through health education and publicity, primary medical institutions development, straightening out medical price system and accelerating insurance policy reform and other measures to guide the target residents through the primary health care services choice and develop the dual referral system.

关 键 词：双诊制 中老年群体 基层医疗服务 PROBIT模型 工具变量法 

分 类 号：R197[医药卫生—卫生事业管理]