| 引用本文：陈思思, 韩曌然, 妥泽贵, 聂瀚林, 严豪, 石学峰.乡村医生学习和使用中医药适宜技术的偏好研究[J].中国卫生政策研究,2023,16(8):47-54 |
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| 乡村医生学习和使用中医药适宜技术的偏好研究 |
| 投稿时间：2023-06-12 修订日期：2023-07-27 PDF全文浏览 HTML全文浏览 |
| 陈思思, 韩曌然, 妥泽贵, 聂瀚林, 严豪, 石学峰 |
| 北京中医药大学管理学院 北京 100029 |
| 摘要:目的：分析乡村医生学习和使用中医药适宜技术的偏好，探讨促进其学习和使用中医药适宜技术积极性的建议，为推动中医药适宜技术在乡村医疗机构的扩散提供参考。方法：采用方便抽样的方法调研了我国17个省236家村卫生室的310名乡村医生，建立条件logit模型进行数据分析，并计算支付意愿和相对重要性。结果：学习的自费费用(β=-0.116)、技术的疗效预期(β=0.493)、学习难度、学习方式、学习单项技术耗时效用显著影响乡村医生学习中医药适宜技术的偏好；月收入的改变(β=0.062)、技术的疗效(β=0.737)、医保(β=0.575)、病人自费费用的改变(β=0.420)、技术单次操作时间、工作负担的改变效用显著影响乡村医生使用中医药适宜技术的偏好；乡村医生在实际学习和使用中医药适宜技术的过程中，还存在许多不足，尤其是自费学习普遍(47.06%)和多种技术不在医保报销范围内(52.94%)的问题。结论：乡村医生对免费学习、能够增加收入、疗效更高、更为简单且能够降低患者疾病经济负担的中医药适宜技术有更好的选择偏好。建议：尽可能降低乡村医生学习中医药适宜技术的经济负担；对使用中医药适宜技术者适当给予经济激励；遴选简单且疗效高的中医药适宜技术进行推广；加快推进中医药适宜技术进入医保。 |
| 关键词:中医药适宜技术 乡村医生 偏好研究 离散选择实验 |
| 基金项目:国家自然科学基金面上项目(7207040925) |
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| A study on the preference of rural doctors in learning and using Appropriate Technologies of Traditional Chinese Medicine |
| CHEN Si-si, HAN Zhao-ran, TUO Ze-gui, NIE Han-lin, YAN Hao, SHI Xue-feng |
| School of Management, Beijing University of Chinese Medicine, Beijing 100029, China |
| Abstract:Objective: This research analyzes the preferences of rural doctors in learning and using appropriate technologies of Chinese medicine, and discusses suggestions to promote their enthusiasm for learning and using appropriate technologies of Chinese medicine, so as to provide reference for promoting the diffusion of Appropriate Technologies of Traditional Chinese Medicine (ATTCM) in rural areas.Method: A convenient sampling method is used to investigate 310 rural doctors in 236 village clinics in 17 provinces in China and a conditional Logit model is established for data analysis, and the willingness to pay and relative importance arecalculated. Result: From large to small, attributes that significantly influence rural doctors' preference for learning ATTCM are learning expenses (β=-0.116), expected technology efficacy (β=0.493), learning difficulty, mode of learning, and time required to learn. From large to small, attributes that significantly influenced rural doctors' preference for using ATTCM are income change (β=0.062), technical efficacy (β=0.737), insurance (β=0.575), changes in out-of-pocket patient expenses (β=0.420), operation time and workload change. However, there are still many challenges when rural doctors learn and use ATTCM in reality, especially the fact that self-funded learning is common (47.06%), and multiple technologies of ATTCMs are not covered by medical insurance (52.94%). Conclusion:ATTCMs that are preferred by rural doctors are those taught for free, with the expectation of income increase, better technical efficacy, and both simple to handle and an expection of reducing patient financial burden. It issuggested that financial burden of rural doctors' learning ATTCM be alleviated, and certain economic incentives be provided for rural doctors who use ATTCM. Meanwhile, promote ATTCM that are easy to practice and function effectively when methods are taken to accelerate the entry of suitable ATTCM into medical insurance. |
| Key words:Appropriate Technologies of Traditional Chinese Medicine (ATTCM) Rural doctors Preference study Discrete choice experiment |
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