| 引用本文：贺焜, 方海.中国居民对家庭医生签约服务内容的偏好研究——基于离散选择实验[J].中国卫生政策研究,2020,13(2):61-66 |
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| 中国居民对家庭医生签约服务内容的偏好研究——基于离散选择实验 |
| 投稿时间：2019-09-27 修订日期：2019-12-12 PDF全文浏览 HTML全文浏览 |
| 贺焜1, 方海2 |
1. 北京大学公共卫生学院 北京 100191;
2. 北京大学中国卫生发展研究中心 北京 100191 |
| 摘要:目的：通过测量中国居民对家庭医生签约服务内容的偏好，为优化家庭医生签约服务内容提供参考依据。方法：基于离散选择实验，通过对北京、上海、杭州、厦门四市共400名社区卫生服务中心就诊居民进行问卷调查，利用条件logistic模型进行分析。结果：纳入分析的8项家庭医生服务内容都具有统计学意义（P<0.05）。其中，慢性病8周长处方相较于2周处方，居民选择签约的OR（Odds Ratio）为3.46；面对面健康咨询与通过电话、网络进行咨询相比较，OR为2.44；疾病治疗免挂号费、诊查费与自费相比，OR为2.24。“8周长处方+免挂号费、诊查费”、“8周长处方+面对面健康咨询”、“8周长处方+4次/年免费上门服务”、“面对面健康咨询+免挂号费、诊查费”这四种服务组合包能使90%以上居民愿意签约家庭医生服务。结论：对于社区就诊居民来说，最吸引其签约家庭医生的服务内容是获得慢性病长处方、面对面健康咨询、疾病治疗减免挂号费和诊查费、一年4次免费上门服务。根据离散选择实验结果可以优化家庭医生服务内容，吸引居民签约家庭医生并增加签约居民的获得感。 |
| 关键词:家庭医生签约 偏好 离散选择实验 |
| 基金项目:国家自然科学基金（71774006） |
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| Research on Chinese residents' preference to family doctors' contract services: Discrete choice experiment |
| HE Kun1, FANG Hai2 |
1. School of Public Health, Peking University, Beijing 100191, China;
2. China Center for Health Development Studies, Peking University, Beijing 100191, China |
| Abstract:Objective: To provide reference for optimizing family doctor contract service by measuring the preference of community residents. Methods: Based on discrete choice experiment, a questionnaire survey was conducted among 400 residents at community health service centers in four cities including Beijing, Shanghai, Hangzhou and Xiamen. Conditional logistic regression was used for analyses. Results: All types of family doctor service studies were statistically significant (P<0.05) in the multivariate regression analyses. In particular, the odds ratio was 3.46 when comparing eight-week prescription to two-week prescription for chronic disease, 2.44 when comparing face-to-face health consultation to telephone or internet consultation, and2.24 when comparing free registration and diagnosis services to self-paying. The four service packages, “eight-week prescription + free registration and diagnosis services”, “eight-week prescription + face-to-face health consultation”, “8-week prescription + free visiting service for four times per year”, and “face-to-face health consultation + free registration and diagnosis services”, enabled more than 90% of residents sign up family doctor contract service. Conclusion: For community residents, the most attractive service items were long-term prescription, face-to-face health consultation, free registration and diagnosis services, and free visiting service for four times per year. According to the results of discrete choice experiment, community health service centers should give more priorities to develop and optimize family doctor services, in order to attract more residents to sign up and increase their sense of gain. |
| Key words:Family doctor contract service Preference Discrete choice experiment |
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