北京地区哮喘患者就医流向的影响因素分析  

Analysis of influencing factors of asthma patients in Beijing choice of hospitals

作　　者：陈吟 郭默宁 CHEN Yin;GUO Moning(Beijing Municipal Health Big Data and Policy Research CenterBeijing Institute of Hospital Management,Beijing100034,China)

机构地区：[1]北京市卫生健康大数据与政策研究中心北京市医院管理研究所,北京100034

出　　处：《中国医药导报》2024年第22期96-101,共6页China Medical Herald

基　　金：首都卫生发展科研专项项目(首发2024-2-3052)。

摘　　要：目的分析北京地区哮喘患者就医流向的影响因素,为进一步优化专科医疗资源布局提供决策参考和建议。方法通过京-卫-信A1-5-1表,采集2016年1月至2020年12月北京郊区哮喘住院患者的病案首页数据。采用二元logistic回归模型分析郊区常住居民就医选择的影响因素,比较近、远郊跨区住院差异。结果区内和跨区住院病例分别为7314、1515例。北京地区哮喘患者跨区住院倾向去区外的三级、综合、公立医院,尤其偏好到执业(助理)医师数(β=0.53,P<0.001)和实有床位数(β=0.16,P=0.001)更多的医疗机构。与城乡居民基本医疗保险患者比较,城镇职工基本医疗保险患者跨区住院比例更高(β=0.96,P<0.001)。年龄越大和住院时间越长的患者,跨区住院比例越低(β=-0.01,P<0.001)。结论北京地区哮喘患者跨区住院率仍较高,远郊区县的专科诊疗能力有待提升,建议考虑老年人群的就医需求,同时通过政策引导和宣传,促进哮喘患者逐步转变就医选择行为,降低患者的就诊负担。Objective To analyze the influencing factors of the asthma patients in Beijing choice of hospitals and to provide data support and suggestions for further optimizing health facility distribution.Methods Case front page data of asthma hospitalized patients in suburban Beijing from January 2016 to December 2020 were collected by means of the Beijing-Health-letter A1-5-1 form.The binary logistic regression model was used to analyze the influencing factors of the choice of medical care for permanent residents in suburban areas,and the differences in hospitalization between near and far-suburban areas across districts were compared.Results There were 7314 and 1515 cases of intra-district and inter-district hospitalization,respectively.In Beijing,patients with asthma tended to go to tertiary,general and public hospitals outside the district,especially to medical institutions with more licensed assisant physicians(β=0.53,P<0.001)and more actually beds(β=0.16,P=0.001).Compared with urban and rural residents’basic medical insurance patients,the proportion of urban employees’basic medical insurance patients in inter-district hospitalization was higher(β=0.96,P<0.001).The older the patients and the longer the hospital stay,the lower the proportion of cross-district hospitalization(β=-0.01,P<0.001).Conclusion The cross-district hospitalization rate of asthma patients in Beijing area is still high,and the specialized diagnosis and treatment ability of suburban counties needs to be improved.It is suggested to consider the medical needs of the elderly population,and promote the gradual change of medical choice behavior of asthma patients through policy guidance and publicity,so as to reduce the medical burden of patients.

关 键 词：就医选择 影响因素 跨区住院 

分 类 号：R197.3[医药卫生—卫生事业管理]