基于Anderson模型的佛山市卫生服务利用公平性及影响因素分析  

Analysis on equity and influencing factors of health service utilizationin Foshan city based on Anderson model

作　　者：朱亚如 张佳伟 韩沛恩 王清波[1] 傅虹桥 杨莉[1] ZHU Ya-ru;ZHANG Jia-wei;HAN Pei-en;WANG Qing-bo;FU Hong-qiao;YANG Li(Public Health School of Beijing University/Health Policy and Technology Assessment Center of Health Department of Beijing University,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院/北京大学医学部卫生政策与技术评估中心,北京100191

出　　处：《卫生软科学》2022年第6期69-73,共5页Soft Science of Health

基　　金：国家自然科学基金-整合视角下基于价值的公共卫生项目评估工具、空间配置及优化研究(72174010);佛山市卫健局项目资助(20200265)。

摘　　要：[目的]探究佛山市居民卫生服务利用的公平性及影响因素,为改善卫生系统公平性提供政策依据。[方法]利用佛山市2018年卫生服务调查数据,采用Tobit回归、集中指数分解法分析卫生服务利用的影响因素,评价公平性。[结果]佛山市两周就诊率和年住院率的集中指数分别为-0.20和-0.11,低收入人群对卫生服务利用更多。促进资源中,参加社会医疗保险的居民门诊和住院服务利用率更低,高收入居民门诊服务利用显著低于最低收入组。需要维度中,自评健康状况较差和慢性病患者的两周就诊率和年住院率更高。[结论]回归分析结果结合集中指数分解法可以提供更为充分的信息;低收入居民、慢性病患者对卫生服务利用的更多,利用与需求较匹配;未享受医保人群可能面临更高的健康风险。Objective To explore the equity and influencing factors of health service utilization among residents in Foshan city,and to provide policy basis for improving equity of health system.Methods Based on the data of health service investigation in Foshan city in 2018,the Tobit regression,concentration index decomposition method were used to analyze the influencing factors of health service utilization and evaluate equity.Results The concentration index of two-week visit rate and annual hospitalization rate in Foshan was-0.20 and-0.11,respectively.The low-income population made more use of health services.Among the promotion resources,the utilization rate of outpatient and inpatient services for residents participating in social medical insurance was lower,and the utilization of outpatient services in high-income residents was significant lower than those of lowest-income.In the need dimension,the two-week visit rate and annual hospitalization rate of people with poor self-rated health status and patients with chronic diseases were higher.Conclusions Regression analysis results combined with concentration index decomposition method may provide more adequate information.Low-income residents and patients with chronic diseases make more use of health services,and their use matches their needs.The uninsured may face higher health risks.

关 键 词：卫生服务利用 ANDERSON模型 集中指数 分解 公平性 影响因素 

分 类 号：R197.1[医药卫生—卫生事业管理]