摘要
目的:分析宁夏农村居民住院医疗机构选择情况及其影响因素,为引导农村居民合理选择医疗机构提供参考依据。方法:基于宁夏农村居民卫生服务调查数据,运用安德森模型分析住院医疗机构选择情况的影响因素,使用边际效应和Shapley值分解法对结果量化估计。结果:住院居民中,选择县域医疗机构占比59.6%,选择非县域医疗机构占比40.4%;婚姻状况、文化程度、年人均收入、职业类型、自评健康状况、慢性病患病情况是农村居民住院医疗机构选择情况的影响因素;Shapley值分解结果为倾向特征(46.09%)贡献度最大,其次是需求因素(40.08%)和使能资源(13.83%)。结论:县域医疗机构是宁夏农村居民住院选择的主要医疗机构;宁夏农村居民住院医疗机构选择情况受婚姻状况、文化程度、年人均收入、职业类型、自评健康状况、慢性病患病情况等因素的共同影响;县域医疗卫生共同体建设要综合考虑需方因素对住院医疗机构选择的影响,积极引导居民理性选择住院医疗机构,优化基层卫生资源配置,提升基层卫生服务利用效率。
Objective:To analyze the selection of inpatient medical institutions for rural residents in Ningxia and its influencing factors,so as to provide a reference basis for guiding rural residents to rationally choose medical institutions.Methods:Based on the data of the follow-up survey of health services for rural residents in Ningxia,Anderson model was used to analyze the influencing factors of inpatient medical institution selection,and marginal effects and Shapley value decomposition methods were used to quantitatively estimate the results.Results:Among the hospitalized residents,59.6%chose county medical institutions and 40.4%chose non-county medical institutions.Marital status,education level,annual per capita income,occupation type,self-rated health status and chronic disease prevalence were the influencing factors of rural residents'choice of inpatient medical institutions.The Shapley value decomposition results showed that the tendency characteristics(46.09%)contributed the most,followed by demand factors(40.08%)and enabling resources(13.83%).Conclusion:County medical institutions are the main medical institutions chosen for hospitalization of rural residents in Ningxia.The choice of inpatient medical institutions for residents in rural areas of Ningxia is affected by factors such as marital status,education level,annual per capita income,occupation type,self-rated health status and chronic disease prevalence.The construction of county medical and health community should comprehensively consider the impact of demand-side factors on the selection of inpatient medical institutions,actively guide residents to rationally choose inpatient medical institutions,optimize the allocation of grassroots health resources and improve the utilization efficiency of grassroots health services.
作者
李春生
王宥匀
宋明莎
乔慧
LI Chunsheng(School of Public Health,Ningxia Medical University,Yinchuan,Ningxia,750004,China)
出处
《医学与社会》
北大核心
2023年第11期27-32,44,共7页
Medicine and Society
基金
国家自然科学基金资助项目,编号为72164033、72264032
宁夏自然科学基金重点项目,编号为2022AAC02036。
关键词
医疗机构选择
住院服务
居民
农村
影响因素
宁夏
Selection of Medical Institution
Inpatient Service
Resident
Rural Area
Influencing Factor
Ningxia
