高邮市城镇慢性病患者就医选择的影响因素研究  

Study on the Influencing Factors of Medical Treatment Choice of Urban Chronic Disease Patients in Gaoyou City

作　　者：曹阳 程同升[1] CAO Yang(Jiangsu Urban Planning and Design Institute,Nanjing,Jiangsu,210036,China)

机构地区：[1]江苏省城市规划设计研究院,江苏南京210036

出　　处：《医学与社会》2020年第10期37-43,共7页Medicine and Society

基　　金：国家自然科学基金资助项目,编号为41571146、41701178。

摘　　要：目的:识别江苏省高邮市慢性病患者就医选择的影响因素及具体作用机制,为提高医疗机构服务能力、制定相关公共卫生政策提供参考。方法:获取1384名慢性病患者的居民健康档案,就其日常就医习惯开展问卷调查,并进行患者就医机构选择、公共卫生服务利用水平以及自身社会经济背景的嵌套多项logistic回归分析。结果:个体因素中患者年龄(β=0.036,P<0.05)、性别(β=0.079,P<0.05)、受教育程度(β=0.034,P<0.05)、收入水平(β=0.018,P<0.05)、自评疾病严重程度(β=0.035,P<0.005)均对其就医选择起显著影响,医疗保险类型与覆盖度(β=0.025,P<0.005)、医疗服务满意度(β=0.042,P<0.05)以及就医便利度(β=0.023,P<0.05)均影响患者就医选择。且患者个体、医疗资源、住区环境三者间存在交互作用关系。结论:建成环境对患者就医选择具有重要影响,公共卫生资源的均衡化供给需要更多考虑患者自身就医需求与实际就医能力。Objective:To identify the influencing factors and specific mechanism of medical treatment choice for chronic disease patients in Gaoyou city,Jiangsu province,to provide a reference for the optimization and improvement of the service capacity of medical institutions and the formulation of relevant public health policies.Methods:The health records of 1384 residents with chronic diseases and the questionnaire survey was conducted on their daily medical habits.The nested multiple logistic regression analysis was performed on the selection of patient medical institutions,the level of public health service utilization,and their socioeconomic background.Results:Individual factors such as age(β=0.036,P<0.05),gender(β=0.079,P<0.05),education level(β=0.034,P<0.05),income level(β=0.018,P<0.05)and self-assessed disease severity(β=0.035,P<0.005),medical insurance types and coverage(β=0.025,P<0.005),medical service satisfaction and convenience(β=0.042,P<0.05)all significantly affected the patient’s choice of medical treatment.There also were interactions among individual patients,medical resources and residential environment.Conclusion:The built environment has an important impact on patients’choice of medical treatment,and the supply of medical resources needs to pay more attention to patients’own medical needs and actual medical ability.

关 键 词：慢性病 就医选择 医住平衡性 患者 高邮 

分 类 号：R19-0[医药卫生—卫生事业管理]