基本医疗服务可及性对居民健康行为的影响  

Influences of basic medical services accessibility on healthy behaviors among residents

作　　者：韩宛彤 井玉荣 秦文哲 胡芳芳 张娇 高兆溶[1,2,3] 洪壮 孔凡磊 徐凌忠 HAN Wantong;JING Yurong;QIN Wenzhe;HU Fangfang;ZHANG Jiao;GAO Zhaorong;HONG Zhuang;KONG Fanlei;XU Lingzhong(Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan,Shandong 250012,China;Shandong University Research Center for Health Economics Experiment and Public Policies,Jinan,Shandong 250012,China;NHC Key Lab of Health Economics and Policy Research(Shandong University),Jinan,Shandong 250012,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,山东济南250012 [2]山东大学卫生经济实验与公共政策研究中心,山东济南250012 [3]国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),山东济南250012

出　　处：《中国农村卫生事业管理》2022年第3期154-159,172,共7页Chinese Rural Health Service Administration

基　　金：国家自然科学基金项目(71974118)。

摘　　要：目的以行为经济学中的助推理论为基础,研究医疗服务可及性能否对居民健康行为产生影响。方法采用多阶段分层整群随机抽样选取8420名居民,运用t检验、方差分析、相关分析和多元线性回归方法分析基本医疗服务可及性对居民健康行为的影响。结果居民健康行为总体得分4.04±1.114分,距最近医疗机构的路程<1 km、离家最近的医疗机构类型是县级及以上,接受过健康体检服务的居民健康行为得分较高(P<0.05),医疗支出占家庭总支出所占比例与居民健康行为得分呈负相关(r=-0.111,P<0.05)。多元线性回归结果显示,地理可及性(β=-0.029)、医疗资源可得性(β=-0.047)、可保障性(β=-0.028)和预防性基本医疗服务可及性(β=-0.102)是影响居民健康行为的影响因素。结论医疗服务可及性是影响居民健康行为的因素,可及性越好,健康行为水平越高。Objective To explore whether the medical services accessibility can have an impact on residents’ health behaviors based on “nudge” theory in behavioral economics. Methods Totally 8420 residents were selected by using a multi-stage stratified random sampling method, and t-test, variance, correlation and multiple linear regression were adopted to analyze the impact of basic medical services accessibility on residents’ health behaviors. Results The overall score of residents’ health behaviors was 4.04±1.114. Residents whose distance from the nearest medical institution was less than 1 km, the type of medical institution closest to whose home was county level and above and who had accepted health examination service had higher scores of health behaviors(P<0.05). The proportion of medical expenditure in total household expenditure was negatively correlated with residents’ health behavior scores(r=-0.111,P<0.05). The multiple linear regression results showed that geographical accessibility(β=-0.029), medical resource availability(β=-0.047), affordability(β=-0.028) and accessibility of preventive basic medical services were the influencing factors for residents’ health behaviors. Conclusions The accessibility of medical services was a factor that affects residents’ health behaviors. The better the accessibility, the higher the level of health behaviors.

关 键 词：医疗服务可及性 健康行为 助推 影响因素 

分 类 号：R197[医药卫生—卫生事业管理] R193[医药卫生—公共卫生与预防医学]