基于倾向得分匹配的家庭医生签约对宁夏中老年人基本公共卫生服务利用的影响研究  

Impact of family doctor contracting on the utilization of basic public health services by middle-aged and elderly people in Ningxia

作　　者：史晓洁 汤榕[1] 杨晓花 马春芳[1] SHI Xiao-jie;TANG Rong;YANG Xiao-hua;MA Chun-fang(School of Humanities and Management,Ningxia Medical University,Yinchuan,Ningxia 750004,China)

机构地区：[1]宁夏医科大学人文与管理学院,宁夏银川750004

出　　处：《现代预防医学》2024年第17期3180-3184,3190,共6页Modern Preventive Medicine

基　　金：宁夏自然科学基金资助项目(2023AAC03233)。

摘　　要：目的评估宁夏回族自治区(简称宁夏)中老年人家庭医生签约对基本公共卫生服务利用的影响。方法基于宁夏自然科学基金资助项目,采取多级分层随机抽样法,选取1997名中老年人的健康相关数据,采用logit模型和倾向得分匹配法,以签约家庭医生样本为处理组,匹配样本特征尽可能相似的未签约家庭医生样本(控制组),探讨宁夏地区中老年人家庭医生签约对基本公共卫生服务利用的影响。结果Logit模型和倾向匹配得分结果显示,签约家庭医生情况与健康档案建立情况和健康教育利用情况之间的系数均显著为正(P<0.01),对应边际效应分别是0.437和0.358,说明宁夏地区相比于没有签约家庭医生的中老年人,签约的中老年人对健康档案建立情况和健康教育利用情况的概率显著高出43.7%和35.8%。在控制了年龄、婚姻状况、文化程度、子女是否给予经济支持、是否患有慢性病五个也会影响中老年人基本公共卫生服务利用的因素后,签约家庭医生对健康档案建立情况平均处理效应值区间为0.877~0.878,签约家庭医生对健康教育利用情况平均处理效应值区间为0.655~0.656,结果显示宁夏地区中老年人家庭医生签约对基本公共卫生服务利用起正向促进作用。结论签约家庭医生有利于提高宁夏地区中老年人对基本公共卫生服务的利用,应加大宣传力度完善宣传方式,提高中老年人知晓率;提供多种、个性化精准的家庭医生服务;加大家庭医生的政策支持,提供更多服务资源。Objective To evaluate the impact of family doctor contracting on the utilization of basic public health services by middle-aged and elderly people in Ningxia.Methods Based on the program from the Natural Science Foundation of Ningxia,a multi-stage stratified random sampling method was used to select health-related data from 1997 middle-aged and elderly individuals.The Logit model and propensity score matching method were employed to explore the impact of family doctor contracting on the utilization of basic public health services in Ningxia.The individuals who sign a contract with a family doctor were grouped into the treatment group,and individuals with similar characteristics who did not sign a contract were selected as the control group.Results The results from the Logit model and propensity score matching showed that the coefficients between family doctor contracting and the establishment of health records and utilization of health education were both significantly positive(P<0.01).The corresponding marginal effects were 0.437 and 0.358,indicating that compared to middle-aged and elderly individuals without a family doctor contract,those with a contract had a significantly higher probability of 43.7%and 35.8%for the establishment of health records and utilization of health education,respectively.After controlling for factors such as age,marital status,education level,financial support from children,and the presence of chronic diseases,the average effect of family doctor contracting on the establishment of health records ranged from 0.877 to 0.878,and the average effect on the utilization of health education ranged from 0.655 to 0.656.These results indicated that family doctor contracting had a positive promoting effect on the utilization of basic public health services by middle-aged and elderly people in Ningxia.Conclusion Signing with a family doctor is beneficial for increasing the utilization of basic public health services by middle-aged and elderly people in Ningxia.Efforts should be made to enhance pub

关 键 词：家庭医生签约 基本公共卫生服务 LOGIT模型 倾向得分匹配 中老年人 

分 类 号：R161.7[医药卫生—公共卫生与预防医学]