| 引用本文：姚强, 吴璇, 郭冰清, 程兆辉, 高娟.高质量发展背景下卫生系统绩效主观测度及影响因素研究——基于CSS 2015—2021调查的实证分析[J].中国卫生政策研究,2024,17(6):17-26 |
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| 高质量发展背景下卫生系统绩效主观测度及影响因素研究——基于CSS 2015—2021调查的实证分析 |
| 投稿时间：2024-03-03 修订日期：2024-06-07 PDF全文浏览 HTML全文浏览 |
| 姚强1,2, 吴璇1, 郭冰清3, 程兆辉4, 高娟1 |
1. 武汉大学政治与公共管理学院 湖北武汉 430072;
2. 武汉大学社会保障研究中心 湖北武汉 430072;
3. 香港大学公共卫生学院 香港 999077;
4. 重庆市卫生健康统计信息中心 重庆 401120 |
| 摘要:高质量发展背景下从主观角度测度卫生系统绩效及其影响因素。利用2015—2021年中国社会状况综合调查数据(Chinese Social Survey，CSS)，基于卫生系统绩效评估框架，从居民获得感视角构建卫生系统绩效指数，通过多层回归模型分析我国卫生系统绩效变化趋势及影响因素。我国卫生系统绩效综合指数从2015年的41.732提高到2021年的46.935，增长了12.47%(β=6.143,P<0.01)。其中，过程指数从43.961提高到45.968，增长了4.57%(β=2.391,P<0.01)，结果指数从48.501提高到58.009，增长了19.60%(β=11.504,P<0.01)。卫生系统绩效获得感呈现出明显的异质性，性别、年龄、受教育程度、婚姻状况、就业状况、经济状况、医保类型和居住地区类型等因素显著影响居民卫生系统绩效的获得感。高质量发展背景下我国卫生系统绩效明显改善，居民获得感显著提高。然而，卫生系统过程维度改善不够，“看病难、看病贵”问题依然存在。需重点加强脆弱人群以及农村地区卫生系统绩效获得感。 |
| 关键词:卫生系统 绩效评估 获得感 影响因素 |
| 基金项目:国家自然科学基金面上项目 (72174149);国家留学基金委促进与加拿大、澳大利亚、新西兰及拉美地区科研合作与高层次人才培养项目(留金美〔2023〕21号)；武汉大学自主科研项目(人文社会科学)数智文科牵引专项(413000171);重庆市2023年科卫联合医学科研面上项目 (2023MSXM029) |
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| Subjective measurement of health system performance and influencing factors in the context of high-quality development: An empirical study based on CSS survey from 2015 to 2021 |
| YAO Qiang1,2, WU Xuan1, GUO Bing-qing3, CHENG Zhao-hui4, GAO Juan1 |
1. School of Politics and Public Administration, Wuhan University, Wuhan Hubei 430072, China;
2. Social Security Research Center, Wuhan University, Wuhan Hubei 430072, China;
3. School of Public Health, The University of Hong Kong, Hong Kong 999077, China;
4. Chongqing Health Statistics and Information Center, Chongqing 401120, China |
| Abstract:Health system performance and its influencing factors are measured from a subjective perspective in the context of high-quality development. Using data from the Chinese Social Survey from 2015 to 2021, this study constructed a health system performance index from the perspective of the sense of acquisition of the population and analyzed the change trends and influencing factors of China's health system performance through a multilayer regression model. The results showed that the comprehensive index of health system performance in China increased by 12.47% (β=6.143, P<0.01) from 41.732 in 2015 to 46.935 in 2021, of which the process index increased by 4.57% (β=2.391, P<0.01) from 43.961 to 45.968, and the outcome index increased from 48.501 to 58.009, an increase of 19.60% (β=11.504, P<0.01). Meanwhile, the sense of access to health system performance showed obvious heterogeneity, with factors such as gender, age, education, marital status, employment status, economic status, type of health insurance and type of area of residence significantly affecting the sense of access to health system performance of residents. The health system performance in China in the context of high-quality development has significantly improved, and the sense of access of residents has significantly increased. However, the improvement in the process dimension of the health system is relatively limited, and "difficult and expensive to see a doctor" remains serious. It’s necessary to strength the health system performance of vulnerable groups, as well as rural areas. |
| Key words:Health system Performance assessment Sense of acquisition Influencing factors |
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