| 引用本文：杜本峰, 王翾, 周丽金, 李炜洁.困境家庭儿童卫生服务利用特征与影响因素——基于安德森健康行为模型的实证研究[J].中国卫生政策研究,2020,13(10):54-61 |
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| 困境家庭儿童卫生服务利用特征与影响因素——基于安德森健康行为模型的实证研究 |
| 投稿时间：2020-07-03 修订日期：2020-10-22 PDF全文浏览 HTML全文浏览 |
| 杜本峰1, 王翾2, 周丽金2, 李炜洁3 |
1. 中国人民大学公共健康与疾病预防控制交叉学科重大创新平台 北京 100872;
2. 中国人民大学社会与人口学院 北京 100872;
3. 中国人民大学财政金融学院 北京 100872 |
| 摘要:目的：评估困境家庭儿童卫生服务利用现状、水平与特征，为开展适度普惠型儿童福利制度提供实证依据。方法：基于安德森卫生服务利用模型，应用t检验、卡方检验和Firth最大似然估计等统计分析方法。结果：困境家庭儿童存在“低门诊率、高住院率”的特征，其中父母重病或重残的情况最突出；困境家庭儿童的促进资源不平衡，与全国平均水平存在较大差距，且卫生服务需要转化为需求的能力较差；困境家庭儿童所处的环境卫生状况差，困境家庭对儿童健康和发展的投入，不仅无法通过陪伴行为体现，也无法通过经济支持行为体现。建议：引导困境家庭提升家庭卫生条件；提升卫生服务可及性；充分发挥医疗保险对困境家庭儿童疾病风险分担作用，降低困境家庭儿童对住院服务的需求；通过社区工作者增加对困境家庭儿童的健康检测，对监护人进行基本保健知识的宣传和培训。 |
| 关键词:困境家庭儿童 安德森模型 卫生服务利用 影响因素 政策干预 |
| 基金项目:教育部人文社会科学重点基地重大项目（17JJD840001）；国家自然科学基金项目（71974194） |
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| Characteristics and influencing factors of child health service utilization in dilemma families: An empirical research based on Anderson health behavior model |
| DU Ben-feng1, WANG Xuan2, ZHOU Li-jin2, LI Wei-jie3 |
1. Major Innovation Platform of Public Health & Disease Control and Prevention, Renmin University of China, Beijing 100872, China;
2. School of Sociology and Population Studies, Renmin University of China, Beijing 100872, China;
3. School of Finance, Renmin University of China, Beijing 100872, China |
| Abstract:Objective: To evaluate the utilization status, level and behavioral characteristics of health services for children from families in distress, so as to provide empirical evidence for the development of a moderately inclusive child welfare system. Methods: This research was carried out based on the Anderson health service utilization model and statistical analysis methods such as t-test, chi-square test and Firth maximum penalty likelihood estimation. Results: Children from dilemma families showed characteristics of “distress” and “circumstances” such as “low outpatient rate and high hospitalization rate”, among which the parents are seriously ill or severely disabled. The promotion resources of children from poor families are unbalanced, which is far from the national average level and those children experience a poor healthcare environment while the ability to meet their needs is also below the average needed. The investment of troubled families in children's health and development cannot only be reflected by companionship behaviors, but also they cannot receive financial support behaviors. Conclusions: A clear guidance is needed for families in distress to improve their health conditions; Access to healthcare services should be improved; The role of medical insurance should be given full play in the sharing of disease risks among children from distressed families and reduce their need for hospitalization services; Health status testing of children from distressed families should be increased and performed through community social workers and advocacy and training of guardians in basic health knowledge as well. |
| Key words:Children of dilemma family Anderson model Health service utilization Influencing factors Policy intervention |
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