基于离散选择实验的社区医务人员中医健康管理服务提供偏好研究  

A study on community healthcare workers preferences for providing Traditional Chinese Medicine health management services based on Discrete Choice Experiment

作　　者：马晓静 许航[2] 潘渝娜 任建萍 MA Xiao-jing;XU Hang;PAN Yu-na;REN Jian-ping(School of Public Health,Hangzhou Normal University,Hangzhou Zhejiang 310036,China;Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100020,China;Peking Union Medical College,Beijing 100730,China)

机构地区：[1]杭州师范大学公共卫生学院,浙江杭州310036 [2]中国医学科学院医学信息研究所,北京100020 [3]北京协和医学院,北京100730

出　　处：《中国卫生政策研究》2025年第3期48-56,共9页Chinese Journal of Health Policy

基　　金：浙江省中医药科技计划项目(2023ZF034);国家自然科学基金项目(71874047)。

摘　　要：目的:研究社区医务人员中医健康管理服务提供偏好和影响因素,为促进中医健康管理服务在社区的推广提供参考。方法:基于离散选择实验,抽取北京市9个行政区共596位社区医务人员进行问卷调查,采用混合Logit模型分析其服务提供偏好。结果:税后月收入变化、预期疗效、单次服务时长、技术难度、患者依从性、医保覆盖对社区医务人员服务提供偏好具有显著影响;税后月收入变化相对重要性最大(35.11%),其次是医保覆盖(34.87%);不同职称、专业背景、每周工作时长以及是否纳入绩效考核对社区医务人员的服务偏好存在异质性。结论:经济因素和非经济因素对于社区医务人员中医服务提供偏好具有不同程度的影响,优化中医健康管理服务属性组合可提高医务人员的服务提供意愿,建议综合运用经济和非经济激励措施,针对不同特征的医务人员制定差异化策略,满足其服务提供偏好,推动社区中医健康管理服务发展。Objective:To investigate the preferences and influencing factors of Traditional Chinese Medicine(TCM)health management services among community healthcare workers,providing a reference for promoting and spreading TCM health management services in communities.Methods:Based on a discrete choice experiment,a questionnaire survey was conducted among 596 community healthcare workers across 9 administrative districts in Beijing.A mixed logit model was used to analyze their preferences.Results:Changes in post-tax monthly income,expected efficacy,single-service duration,technical difficulty,patient compliance,and insurance coverage significantly influenced community doctors service preferences.Changes in post-tax monthly income had the highest relative importance(35.11%),followed by insurance coverage(34.87%).Preferences varied among healthcare workers with different professional titles,backgrounds,weekly working hours,and whether the service was included in performance evaluations.Conclusion:Both economic and non-economic factors influence community healthcare workers service preferences to varying degrees.Optimizing the combination of TCM health management service attributes can enhance community healthcare workers willingness to provide such services.It is recommended to use a combination of economic and non-economic incentive measures and develop differentiated strategies for healthcare workers with different characteristics to meet their service preferences and promote the development of TCM health management services in communities.

关 键 词：社区医务人员 中医 健康管理服务 偏好 离散选择实验 

分 类 号：R197[医药卫生—卫生事业管理]