广东省城乡居民基本医疗保险参保者基层首诊意愿的影响因素分析  

Analysis on Influencing Factors of Willingness of First-visit at Grassroots Medical Institution Among Basic Medical Insurance Scheme for Urban and Rural Residents Insured Residents in Guangdong Province

作　　者：安然 秦立建[3] 杨晓胜 郭建 AN Ran(School of Humanities and Management,Guangdong Medical University,Dongguan,Guangdong,523079,China)

机构地区：[1]广东医科大学人文与管理学院,广东东莞523079 [2]菲律宾克里斯汀大学国际学院,菲律宾马尼拉1004 [3]安徽财经大学中国健康经济研究中心,安徽蚌埠233000

出　　处：《医学与社会》2022年第11期61-65,共5页Medicine and Society

基　　金：国家社会科学基金资助项目,编号为18FGL014;教育部人文社科项目,编号为18YJA790065;安徽省社科规划基金重大项目,编号为AHSKZD2019D04;安徽省社科规划项目,编号为AHSKY2020D44;安徽省社科规划基金项目,编号为AHSKY2017D01;广东医科大学青年培育基金,编号为GDMUQ2021062;安徽财经大学重点科研项目,编号为ACKYB20016。

摘　　要：目的:分析广东省城乡居民基本医疗保险参保者基层首诊意愿及其影响因素,为促进落实基层首诊提供实证依据和政策建议。方法:采用多阶段抽样法对广东省东莞市、惠州市和湛江市城乡居民基本医疗保险参保者进行问卷调查,得到911份有效问卷,在控制人口因素、经济因素的基础上,利用Probit模型,通过4个实证模型逐次增加变量和分组聚类进行分析。结果:城乡居民基本医疗保险参保者患病时首选基层医疗机构就诊的占比依次为东莞市(59.02%)、惠州市(52.16%)和湛江市(48.52%);男性、年龄较大、文化程度较低、农业户口、家庭年收入低、已签约家庭医生、对医保补偿政策关注度高的参保居民更易选择基层首诊。结论:不同地区城乡居民基本医疗保险参保者基层首诊意愿存在差异,提高参保者对医保补偿政策的关注度,提升家庭医生签约覆盖率能够促进参保者首选基层就诊。Objective:To analyze the willingness of first-visit at grassroots medical institution among basic medical insurance scheme for urban and rural residents participants in Guangdong province and their influencing factors,so as to provide empirical basis and policy recommendations for promoting the implementation of the first-visit at grassroots medical institution.Methods:Participants of basic medical insurance scheme for urban and rural residents in Dongguan,Huizhou and Zhanjiang of Guangdong province were investigated by multi-stage sampling,911 effective questionnaires were obtained.On the basis of controlling demographic factors and economic factors,probit model was used to add variables and cluster analysis through 4 empirical models.Results:Proportion of first-visit at grassroots medical institution willingness by basic medical insurance scheme for urban and rural residents participants was Dongguan(59.02%),Huizhou(52.16%)and Zhanjiang(48.52%).Male,older,less educated,agricultural registered permanent residence,low annual family income,contracted family doctors and insured residents with high attention to medical insurance compensation policies were more likely to choose first-visit at grassroots medical institution.Conclusion:There are differences in the first-visit at grassroots medical institution willingness of basic medical insurance scheme for urban and rural residents in different regions.Improving the insured's attention to the medical insurance compensation policy and improving the contract coverage rate of family doctors can promote the insured's first-visit at grassroots medical institution.

关 键 词：基层首诊 城乡居民基本医疗保险 意愿 广东 

分 类 号：R197.1[医药卫生—卫生事业管理]