基于离散选择实验的乌鲁木齐市居民健康管理服务选择偏好研究  

Preference of Health Management Services in Urumqi Residents:a Discrete Choice Experiment Study

作　　者：苏天园 李豫凯[2] 张其其 庄玮 SU Tianyuan;LI Yukai;ZHANG Qiqi;ZHUANG Wei(Telemedicine Center,the First Affiliated Hospital,Xinjiang Medical University,Urumqi 830011,China;School of Public Health,Xinjiang Medical University,Urumqi 830011,China;Postdoctoral Station in Applied Economics,Xinjiang University of Finance&Economics,Urumqi 830011,China;School of Marxism,Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院远程医学中心,新疆维吾尔自治区乌鲁木齐市830011 [2]新疆医科大学公共卫生学院,新疆维吾尔自治区乌鲁木齐市830011 [3]新疆财经大学应用经济学博士后站,新疆维吾尔自治区乌鲁木齐市830011 [4]新疆医科大学马克思主义学院,新疆维吾尔自治区乌鲁木齐市830011

出　　处：《中国全科医学》2021年第16期2015-2021,共7页Chinese General Practice

基　　金：新疆维吾尔自治区自然科学青年基金项目(2019D01C202)。

摘　　要：背景随着大众健康观念的转变,人群健康管理需求和消费能力有所提升,在当前供给侧结构性改革的大背景下,如何从供需两端发力,对居民健康管理消费需求和行为加以合理的引导,成为亟待研究的问题。目的通过了解居民选择健康管理服务时的权衡过程及其偏好,以居民真实的健康管理服务需求为依据,为政策制定者和健康管理服务供给方提供决策依据。方法采用简单随机抽样和方便抽样相结合的方法于2019年7-10月在乌鲁木齐市7个区展开离散选择实验问卷调查。问卷包括调查对象基本信息、离散选择实验选择集(共包括服务主体、服务内容、线上服务提供情况、中医药服务提供情况、家庭医生签约服务提供情况、自付费用6个属性,每个属性又包括若干水平)。运用Stata 15.0软件构建离散选择模型,采用混合Logit回归模型分析居民健康管理服务选择偏好。结果共发放问卷945份,回收有效问卷802份,有效回收率为84.9%。离散选择模型结果显示,居民效用最高的健康管理服务组合方案为公立医院健康管理部门、健康体检+健康教育与咨询或健康体检+健康干预、丰富的线上服务、有中医药服务、有家庭医生签约服务(P<0.05)。结论乌鲁木齐市居民在选择健康管理服务时最关心服务主体,对服务内容的潜在需求仍需引导,居民对线上服务、中医药服务和家庭医生签约服务存在偏好。目前应该加大宣传力度和政策指引,充分发挥各类健康管理机构在健康管理中的作用,完善线上线下的服务闭环,积极引进中医慢性病防控的服务方式,持续推进家庭医生签约服务的有序进行。Background As public health concept changes,the people's health management needs and consumption capacity have increased.Under the context of supply-side structural reform in healthcare field,how to rationally guide residents'healthcare needs and consumption as well as healthcare-seeking behaviors via supply-demand measures,has become an issue to be solved urgently.Objective To explore the trade-off process and result of choosing a preferred health management service in residents in accordance with their real health needs,providing a decision-making basis for policy makers and health management service providers.Methods Simple random sampling and convenience sampling were used to select participants for a questionnaire survey using a discrete choice experiment design from seven districts of Urumqi from July to October 2019.The questionnaire includes:basic demographic information,and the choice set of discrete choice experiments〔including the service provider,service scope,provision of online healthcare services,traditional Chinese medicine(TCM)services,and contracted family doctor services,as well as out-of-pocket expenses,with each attribute including several levels〕.Stata 15.0 was used to build a discrete choice model.Mixed Logit regression model was used to analyze residents'preference of health management services.Results A total of 945 individuals attended the survey,and 802 of them(84.9%)who responded effectively were enrolled finally.Discrete choice analysis demonstrated that the most frequently used combined health management scheme was:health management department of public hospitals,health examination,health education with health consultation or health examination with health intervention,abundant online healthcare services,TCM services,and contracted family doctor services(P<0.05).Conclusion Urumqi residents are most concerned about service provider when choosing health management services,and their potential demand for service still needs to be guided.Meanwhile,they have preferences for online hea

关 键 词：健康管理 偏好 离散选择实验 离散选择模型 

分 类 号：R197[医药卫生—卫生事业管理]