基于安德森模型的患者就医机构选择研究  

Study on selection of patient medical institutions based on Anderson model

作　　者：刘珍珍 杜涛[1] 杨嘉领 LIU Zhenzhen;DU Tao;YANG Jialing(School of Economics and Management,Yanan University,Yanan 716000,China)

机构地区：[1]延安大学经济与管理学院,陕西延安716000

出　　处：《现代医院》2021年第12期1812-1817,共6页Modern Hospitals

基　　金：国家自然科学基金项目(71964034);延安大学2018年博士科研启动项目(YDBK2018-38)。

摘　　要：目的分析医联体(医疗联合体)背景下患者就医机构选择及其影响因素,为促进分级诊疗、实现基层首诊目标提供政策参考。方法基于延安医疗集团下属的十家医疗机构的调查数据,根据安德森医疗服务利用模型并结合因子分析法降维确定变量指标,采用描述统计和多项Logistic回归方法对患者就医机构选择及其影响因素进行分析,综合主要影响因素提出相关建议。结果医疗服务质量是影响患者机构选择的共同因素,医疗服务可及性作用于二级医院选择;年龄、职业、就诊科室表征的疾病类型对各级医疗机构选择均有影响;文化程度、居住地对社区卫生中心就医选择影响更明显。结论综合考虑患者倾向特征、使能资源、健康需求和就医感知,提供相应的政策支持,构建"以患者为中心"的医联体医疗服务体系,引导患者合理就医。Objective To analyze the choice of medical institutions as well as the influencing factors affecting it and provide policy reference for promoting hierarchical diagnosis and treatment and realizing the goal of the first diagnosis at the grassroots level. Methods We use the survey data of ten medical institutions under Yanan Medical Group. Variate index were determined by dimension reduction of factor analysis and Anderson model. We analyze the selection of medical institution and the main influencing factors combining with the analysis of description statistics and Logistic regression methods. Relevant advice arises from main influence factors. Results The quality of medical service is the common factors affecting the choice of patient institutions, and the accessibility of medical services acts on the choice of secondary hospitals;diseases characterized by age, occupation and medical departments which represent the type of disease has an impact on the selection of medical institutions at all levels;culture and residence influence more significantly on the selection of community health centers. Conclusion Comprehensively consider the characteristics of patients’ identity, enabling resources, health demand and medical perception, provide corresponding policy support, build a “patient-centered” medical association medical service system, and guide patients to seek reasonable medical treatment.

关 键 词：就医机构选择 安德森模型 医联体 LOGISTIC回归 

分 类 号：R197.1[医药卫生—卫生事业管理]