| 引用本文：何艳平, 张晓丹, 姚强.家庭医生签约服务的健康效应及作用机制研究——来自6省12县1 191位农村慢性病患者的证据[J].中国卫生政策研究,2024,17(8):19-27 |
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| 家庭医生签约服务的健康效应及作用机制研究——来自6省12县1 191位农村慢性病患者的证据 |
| 投稿时间：2024-04-24 修订日期：2024-07-19 PDF全文浏览 HTML全文浏览 |
| 何艳平1, 张晓丹1, 姚强1,2 |
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 |
| 摘要:目的：探究家庭医生签约服务对农村慢性病患者健康的影响及作用机制。方法：2023年6—8月，通过面对面问卷调查收集了6省12县有效样本1 191份，利用Tobit模型和KHB方法分析家庭医生签约服务对EQ-5D-5L效用值的影响和作用路径。结果：我国农村地区慢性病患者家庭医生签约率为59.19%，健康效用值为0.831；家庭医生签约服务显著提高了慢性病患者的效用值(β=0.047，P<0.05)；且通过公共卫生服务利用完全中介路径影响效用值(β=0.028，P<0.01，95%CI=0.009~0.047)，间接效应占总效应的66.77%。结论：我国农村地区慢性病患者家庭医生签约率较低，健康相关生命质量较差，我国家庭医生签约服务主要通过提高公共卫生服务利用改善慢性病患者健康状况，尚需加强家庭医生签约服务在医疗服务利用和个人自我保健行为方面的影响，以充分发挥家庭医生签约服务的综合健康效应。 |
| 关键词:家庭医生签约服务 慢性病患者 健康相关生命质量 健康效用作用机制 KHB中介分析 |
| 基金项目:武汉大学2024年大学生创新训练国家级项目 (202410486020);2023年武汉大学本科教育质量建设综合改革项目(一流本科专业建设项目);国家自然科学基金面上项目 (72174149)和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) |
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| The health effect and its mechanism of family doctor contract services: Evidence from 1 191 rural residents with chronic diseases in 12 counties of 6 provinces |
| HE Yan-ping1, ZHANG Xiao-dan1, YAO Qiang1,2 |
1. School of Politics and Public Administration, Wuhan University, Wuhan Hubei 430072, China;
2. Social Security Research Center, Wuhan University, Wuhan Hubei 430072, China |
| Abstract:Objective: To explore the effect and mechanism of family doctor contract services on the health of rural residents with chronic diseases. Methods: From June to August 2023, 1 191 valid samples from 12 counties in 6 provinces were collected through face-to-face questionnaire survey. Tobit model and KHB method were used to analyze the effect of family doctor contract services on EQ-5D-5L utility index scores and its path. Results: The family doctor contract rate was 59.19% and the utility index score was 0.831. Family doctor contract services significantly improved the health utility index scores of chronic disease patients (β=0.047, P<0.05); The utility index score was affected completely through public health services (β=0.028, P<0.01, 95%CI=0.009~0.047), and the indirect effect accounted for 66.77% of the total effect. Conclusion: The family doctor contract rate of rural residents with chronic diseases is low in China, and the health-related quality of life is not good. The family doctor contract services can improve the health-related quality of life of patients with chronic diseases mainly by improving public health services. It is urgent to strengthen the effects of family doctor contract services on medical service utilization and individual health behavior, so as to give full play to the health effects of family doctor contract services. |
| Key words:Family doctor contract services Patients with chronic diseases Health-related quality of life Health effect KHB mediation analysis |
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