[1]任艳丽,童恩煜,狄春红,等.基于2018年CHARLS调查数据的中老年群体首诊就医选择及其影响因素[J].医学信息,2022,35(10):40-43.[doi:10.3969/j.issn.1006-1959.2022.10.009]
　REN Yan-li,TONG En-yu,DI Chun-hong,et al.Selection and Influencing Factors of First Consultation for Middle-aged and Elderly Population Based on CHARLS Data in 2018[J].Medical Information,2022,35(10):40-43.[doi:10.3969/j.issn.1006-1959.2022.10.009]
点击复制

基于2018年CHARLS调查数据的中老年群体首诊就医选择及其影响因素()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年10期
页码:
40-43
栏目:
临床信息学
出版日期:
2022-05-15

文章信息/Info

Title:
Selection and Influencing Factors of First Consultation for Middle-aged and Elderly Population Based on CHARLS Data in 2018
文章编号:
1006-1959（2022）10-0040-04
作者:
任艳丽; 童恩煜; 狄春红; 等
（1.杭州师范大学公共卫生学院，浙江 杭州 311121；2.杭州师范大学附属医院检验科，浙江 杭州 310015）
Author(s):
REN Yan-li; TONG En-yu; DI Chun-hong; et al.
(1.School of Public Health,Hangzhou Normal University,Hangzhou 311121,Zhejiang,China;2.Department of Laboratory,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang,China)
关键词:
中老年人; 就医行为; 首诊选择; 医疗保险
Keywords:
Middle-aged and elderly; Health seeking behavior; First diagnosis selection; Medical insurance
分类号:
R197
DOI:
10.3969/j.issn.1006-1959.2022.10.009
文献标志码:
A
摘要:
目的 了解我国现阶段中老年群体在患病时就医首诊选择情况及其影响因素。方法 数据来源于中国健康与养老追踪调查（CHARLS）2018年的调查数据，纳入样本量为1196人。对中老年人首诊就医行为选择的不同特征进行描述性统计分析，采用多因素Logistic回归来分析其主要影响因素。结果 有50.76%的中老年居民在患病时首诊选择基层医疗机构，有49.24%的中老年居民选择医院；不同年龄、居住地、文化程度及是否具有城镇职工医疗保险、城镇居民医疗保险、新农合的中老年居民首诊就医行为选择比较，差异有统计学意义（P＜0.1）；多因素Logistic回归分析显示，居住地、文化程度和医疗保险对中老年居民首诊选择具有显著影响。结论 我国中老年居民基层首诊率不太理想，建议通过医疗资源配置向基层倾斜，加强基层医疗人才队伍建设，加强基层卫生服务机构的药品供应保障，医保报销政策引导，简化转诊程序，宣传分级诊疗，发展医生多点执业制度等途径来提高中老年居民的基层首诊率。
Abstract:
Objective To understand the first consultation selection and its influencing factors of middle-aged and elderly people in China at present.Methods Using data from the China Health and Elderly Care Tracking Survey (CHARLS) in 2018, with a sample size of 1196 people. Descriptive statistical analysis was carried out on the different characteristics of the first consultation behavior choice of middle-aged and elderly people, and multivariate Logistic regression was used to analyze the main influencing factors.Results 50.76% of middle-aged and elderly residents chose primary medical institutions for the first consultation when they were sick, and 49.24% of middle-aged and elderly residents chose hospitals. There were significant differences in age, place of residence, educational level and the choice of first visit medical behavior among middle-aged and elderly residents with or without medical insurance for urban workers, medical insurance for urban residents and new rural cooperative medical system (P<0.1); multivariate Logistic regression analysis showed that residence, education level and medical insurance had significant influence on the first visit choice of middle-aged and elderly residents.Conclusion The first consultation rate of middle-aged and elderly residents in our country is not ideal. It is recommended that the allocation of medical resources should be tilted to the grassroots level, strengthen the construction of the grassroots medical talent team, strengthen the drug supply guarantee of the grassroots health service institutions, guide the medical insurance reimbursement policy, simplify the referral procedure, and publicize Hierarchical diagnosis and treatment, and the development of a multi-point practice system for doctors to increase the first diagnosis rate of middle-aged and elderly residents.

参考文献/References:

[1]蒋春灵,付建华,李银才.我国基层医疗机构服务能力弱化的体制探源[J].中国卫生经济,2018,37(10):54-57.[2]赵汉澜,钟敏.关于我国“看病难、看病贵”的困境与政策改进[J].农村经济与科技,2019,30(16):149-150.[3]于洗河,顾文涛,万龙涛,等.吉林省县级公立医院改革后“看病难、看病贵”现状研究[J].中国卫生经济,2018,37(2):45-47.[4]李勇,邢影影.分级诊疗背景下患者门诊就医选择行为实证研究[J].中国医院管理,2020,40(6):50-54.[5]曾雁冰,袁志鹏,方亚.中国老年人就医行为及其影响因素研究[J].中国卫生统计,2020,37(2):199-205.[6]高和荣.健康治理与中国分级诊疗制度[J].公共管理学报,2017,14(2):139-44,59.[7]郭燕红.推进分级诊疗，构建连续健康服务[J].中国全科医学,2017,20(1):1-5.[8]张瑞洁,李晶华,马天娇,等.我国中老年群体首诊医疗机构选择行为及其影响因素[J].医学与社会,2020,33(6):22-25.[9]Liu Y,Zhong L,Yuan S,et al.Why patients prefer high-level healthcare facilities: a qualitative study using focus groups in rural and urban China[J].BMJ Glob Health,2018,3(5):e000854.[10]Liu Y,Kong Q,Yuan S,et al.Factors influencing choice of health system access level in China: A systematic review[J].PLoS One,2018,13(8):e0201887.[11]章豪,周典.分级诊疗制度下社区卫生服务中心的困境及对策[J].中国卫生资源,2016,19(4):326-329.[12]周德权,朱菁,杜李新,等.分级诊疗制度下患者首诊意向及影响因素分析——基于江苏省综合性医院的调查[J].现代商贸工业,2018,39(28):70-73.[13]陈思洁,李宁秀.成都市居民首诊机构选择及影响因素分析[J].中国卫生事业管理,2013,30(6):477-479.[14]李寒寒,苗春霞,姜金星,等.基于城乡居民就医机构选择的分级诊疗制度实施效果分析[J].医学与哲学,2018,39(12):67-71.[15]王紫红,郑慧凌,苏敏艳,等.城乡医疗资源配置差异对分级诊疗实施的影响——基于中国居民就医选择分析[J].卫生软科学,2021,35(3):27-30.[16]苗春霞,卓朗,李寒寒,等.分级诊疗制度下徐州市社区居民的社区卫生服务机构首诊情况及影响因素研究[J].中国全科医学,2017,20(25):3104-3108.[17]张蕾,张南,姚华.我国分级诊疗新进展及瓶颈[J].中国医院,2016,20(11):66-68.[18]王丽君,鲁志鸿,李友卫,等.山东省城乡居民基层医疗机构首诊和转诊意愿及其影响因素分析[J].中国公共卫生,2021,37(3):465-469.[19]李涵相,白永凯,王留义.综合医院全科医学科指导基层卫生服务的SWOT分析[J].中华全科医学,2021,19(3):341-344.

相似文献/References:

[1]贾晓灿.我国中老年人肥胖对抑郁的影响[J].医学信息,2023,36(15):104.[doi:10.3969/j.issn.1006-1959.2023.15.020]
　JIA Xiao-can.Effect of Obesity on Depression in Middle-aged and Elderly People in China[J].Medical Information,2023,36(10):104.[doi:10.3969/j.issn.1006-1959.2023.15.020]

更新日期/Last Update: 1900-01-01