| 引用本文：吴文琪, 林琳, 张亮, 张研.县乡医生医疗服务提供决定因素分析——基于中部地区两个县的调查[J].中国卫生政策研究,2019,12(3):32-37 |
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| 县乡医生医疗服务提供决定因素分析——基于中部地区两个县的调查 |
| 投稿时间：2018-02-01 修订日期：2018-11-28 PDF全文浏览 HTML全文浏览 |
| 吴文琪1,2, 林琳1,2, 张亮1,2, 张研1,2 |
1. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;
2. 湖北省人文社科重点研究基地农村健康服务研究中心 湖北武汉 430030 |
| 摘要:目的：了解医生为患者进行诊疗时决策因素的实际变化，为引导合理医疗服务提供依据。方法：采用典型整群抽样方法开展问卷调查，描述性分析决策因素变化，并进行方差分析。结果：疾病情况（26.9%）、纠纷风险（22.8%）、政策要求（19.4%）、便捷程度（18.0%）、个人收入（12.9%）五个因素对服务提供影响的权重依次下降；疾病情况权重随年龄增长由23.6%增长到33.0%，同时在收入占家庭收入比重较高的医生中的差异具有显著性；纠纷风险权重更高的是男医生（23.7±8.0）；个人收入权重随医生年龄增大而减小（P<0.01）。结论：现实中的医生并非“完全健康代理人”；医生提供诊疗服务时仍以疾病情况为首要因素，但其他因素的影响不容忽视；医生的个人特征及家庭背景对服务决策存在影响。 |
| 关键词:医疗服务 医疗机构 决策因素 |
| 基金项目:国家青年自然科学基金项目（71603088） |
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| Analysis on the determinants of medical services provided by county and township doctors in china's central region |
| WU Wen-qi1,2, LIN Lin1,2, ZHANG Liang1,2, ZHANG Yan1,2 |
1. School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei 430030, China;
2. Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan Hubei 430030, China |
| Abstract:Objective:This paper aims to understand the actual changes in the decision-making factors when doctors provide medical services to patients, and to guide the provision of reasonable medical services. Methods:In this study, a typical cluster sampling method is used to conduct a questionnaire survey. The descriptive analysis and analysis of variance methods are then used to interpret the data. Results:The average weights of the five decision-making factors while providing medical services, namely type of disease, risk of disputes, policy requirements, degree of convenience and personal income, decrease successively. Compared with the control group, the weight of disease type is higher among the elderly doctors and county-level doctors. Those with higher weight of dispute risk are male doctors and doctors with a higher proportion of family income. The weight of individual income is higher for female doctors and young doctors; while township doctors and female doctors are given higher convenience ratings. Conclusions:In reality, doctors are not "fully health agents". When doctors are providing medical services, the state of illness is still the primary decision-making factor, but the influence of other factors cannot be ignored. The personal characteristics and family background have a significant impact on the decision-making of doctors. |
| Key words:Medical services Medical institutions Decision-making factors |
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