传染病患者首诊医疗机构选择的影响因素分析及预测模型研究  

Influencing Factors and Predictive Modeling of the Selection of Infectious Disease Patients'First Choosing Institution

作　　者：顾肖肖 田昕 魏佳特 辛有清[3] 吴晓林 吴冕 Gu Xiaoxiao;Tian Xin;Wei Jiate(Capital Medical University,Beijing,100069,China;不详)

机构地区：[1]首都医科大学,北京100069 [2]首都医科大学附属北京地坛医院,北京100015 [3]首都医科大学附属北京友谊医院,北京100050 [4]北京市通州区永顺社区卫生服务中心,北京101100

出　　处：《中国医院管理》2024年第9期32-36,共5页Chinese Hospital Management

基　　金：首都卫生发展科研专项(首发2022-4G-20219);北京市通州区科技计划项目(KJ2022CX038)。

摘　　要：目的建立消化道和呼吸道传染病患者首诊医疗机构选择预测模型并分析其影响因素,为医疗机构精准防治传染病提供参考。方法通过整群抽样方法,抽取北京市通州区某医联体覆盖区域内1524例消化道和呼吸道传染病患者。将患者数据按照8∶2随机分成训练集和测试集,采用二元logistic回归模型分析患者首诊医疗机构选择的影响因素并建立预测模型,通过测试集中受试者工作特征(receiver operating characteristic,ROC)曲线下的面积(area under the curve,AUC)评价模型预测效果。结果1524例患者中,有417例选择社区首诊。文化水平、医保类型、职业、相对距离、是否签约家庭医生是传染病患者选择首诊医疗机构的影响因素。测试集的AUC=0.851,模型拟合效果较好。结论通过建立传染病患者首诊医疗机构预测模型可用来预测患者流向,帮助区域合理配置医疗资源,提高区域内传染病患者基层首诊率。Objective To establish a predictive model for digestive and respiratory infectious disease patients’selection of first-entry healthcare institutions and analyze the influencing factors,providing a reference for regional healthcare institution development.Methods The cluster sampling was used to select 1524 target patients.The data was randomly split 8:2 into training and testing sets.The binary logistic regression method was employed to establish a predictive model for the selection of infectious disease patients’first choosing institution and analyze the influencing factors.The model's predictive performance was evaluated using the AUC of the testing set Results It analyzed 1524 infectious disease cases;417 chose community clinics first.Influences on their initial choice included education,insurance type,occupation,relative distance,and having a family doctor.The AUC of the test set was 0.851.Conclusion The predictive model of the selection of infectious disease patients’first choosing institution established in this study can be used to predict patient flow and help allocate medical resources reasonably.Increasing the rate of primary care for patients with infectious diseases in the region.

关 键 词：传染病 首诊医疗机构 影响因素 预测模型 

分 类 号：R197.1[医药卫生—卫生事业管理]