[目的]对比2011年和2021年中国居民医疗系统综合评价水平及其影响因素,分析其10年变迁,为深化我国医药卫生体制改革,促进医疗卫生系统可持续发展提供实证依据。[方法]利用2011年和2021年中国综合社会调查(CGSS)数据,构建包含人口特征、社会环境和医疗服务的三维居民医疗系统综合评价影响因素分析框架,借助SPSS等工具完成差异建立多元线性回归模型,分析居民医疗系统综合评价的影响因素。[结果]2021年我国居民对医疗卫生系统综合评价水平的均值为3.97,较2011年(3.50)有所提高。近期诊疗满意度(2021年β=0.311,2011年β=0.310)、优质医疗可及性(2021年β=0.234,2011年β=0.156)是居民医疗系统综合评价的最主要的影响因素。[结论]10年间居民对医疗卫生系统的综合评价水平有所提升,居民对医疗系统的综合评价时最关注的是医疗服务质量和医疗资源可及性,提高促进居民社会公平感和对当地政府的信任程度的提高有助于提升其对医疗系统的综合评价水平。
Abstract
Objective This paper compares Chinese residents' comprehensive evaluation of healthcare system and its influencing factors in 2011 and 2021,and analyzes its changes in the past 10 years, providing empirical evidence for deepening the reform of China's medical and healthcare system and promoting the sustainable development of medical and healthcare system. Methods Based on the data of 2011 and 2021 China General Social Survey (CGSS), a three-dimensional analytical framework for the factors influencing the residents' comprehensive evaluation of the healthcare system, including demographic characteristics, social environment and medical services, was constructed. SPSS and other tools were used to complete the analysis of differences and establish a multivariate linear regression model to analyze the factors influencing the residents' comprehensive evaluation of healthcare system. Results The mean value of comprehensive evaluation of the medical and health system of Chinese residents in 2021 was 3.97, which was higher than that in 2011 (3.50). Recent diagnosis and treatment satisfaction (β=0.311 in 2021, β=0.310 in 2011) and access to quality healthcare (β=0.234 in 2021, β=0.156 in 2011) were the most important factors influencing the residents' comprehensive evaluation of healthcare system. Conclusions Residents' overall evaluation of the medical and healthcare system has been improved over the past 10 years. The quality of medical services and the accessibility of medical resources are the most important concerns in residents' comprehensive evaluation of the healthcare system. The improvement of residents' sense of social justice and trust in the local government help improve their comprehensive evaluation of the healthcare system.
关键词
居民 /
医疗系统 /
综合评价 /
中国综合社会调查 /
影响因素 /
医疗服务
{{custom_keyword}} /
Key words
residents /
healthcare system /
comprehensive evaluation /
China General Social Survey /
influencing factors /
medical services
{{custom_keyword}} /
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] ÖZGÜR UĞURLUOĞLU, DUYGU ÜREK, iPEK BILGIN DEMIR.Evaluation of Individuals' Satisfaction with Health Care Services in Turkey[J].Health Policy and Technology,2019,8(1):24-29.
[2] KRUK ME,KAPOOR NR,LEWIS TP,et al.Population Confidence in the Health System in 15 Countries:Results from the First Round of the People's Voice Survey[J].Lancet Glob Health,2024,12(1):E100-E111.
[3] SVORONOS T,MACAULEY RJ,KRUK ME.Can the Health System Deliver? Determinants of Rural Liberians' Confidence in Health Care[J].Health Policy Plan,2015,30(7):823-829.
[4] VALLS MARTÍNEZ MC,ABAD SEGURA E.Patient Satisfaction in the Spanish National Health System[J].An Sist Sanit Navar,2018,41(3):309-320.
[5] RODER-DEWAN S,GAGE A,HIRSCHHORN LR,et al. Level of Confidence in and Endorsement of the Health System among Internet Users in 12 Low-income and Middle-income Countries[J].BMJ Glob Health,2020,5(8):E002205.
[6] SADEGHI-BAZARGANI H,FARAHBAKHSH M,TABRIZI JS,et al.Psychometric Properties of Primary Health Care Trust Questionnaire[J].BMC Health Serv Res,2019,19(1):502-506.
[7] BAROUDI M,GOICOLEA I,HURTIG AK,et al.Social Factors Associated with Trust in the Health System in Northern Sweden:A Cross-sectional Study[J].BMC Public Health,2022,22(1):881-888.
[8] NIKODEM K,ĆURKOVIĆ M,BOROVEČKI A.Trust in the Healthcare System and Physicians in Croatia: A Survey of the General Population[J].Int J environ Res Public Health,2022,19(2):993-1010.
[9] MECHANIC D,MEYER S.Concepts of Trust among Patients With Serious Illness[J].Soc Sci Med,2000 51(5):657-68.
[10] KAO AC,GREEN DC,ZASLAVSKY AM,et al.The Rela-tionship between Method of Physician Payment and Patient Trust[J].Jama,1998,280(19):1708-1714.
[11] GORDON HS,OKSANA P,BERBAUM ML, et al.Examining Patients' Trust in Physicians and the Va Healthcare System in A Prospective Cohort Followed for Six-months after An Exacer-bation of Heart Failure[J].Patient Education & Counseling,2014,97(2):173-179.
[12] MUNRO N,DUCKETT J.Explaining Public Satisfaction with Health-care Systems: Findings from A Nationwide Survey in China[J].Health Expect,2016,19(3):654-666.
[13] 王少群.患者参与、医患心理契约违背与患者信任的关系研究[D].杭州:浙江师范大学,2010.
[14] ZHAO DH, RAO KQ, ZHANG ZR.Patient Trust in Physi-cians:Empirical Evidence from Shanghai,China[J].Chinese Medical Journal,2016,129(7):814-818.
[15] 吴亮锋,任建萍,王锦晶,等.杭州市基层医疗卫生机构慢性颈肩痛患者社区中医师信任度调查[J].中国卫生事业管理,2024,41(2):142-145.
[16] 夏 春.安徽省农村居民医疗机构信任现状与影响因素[J].农村经济与科技,2022,33(6):151-153.
[17] 林铠浩,蔡伟聪,梁诗言,等.深圳市居民医疗卫生服务利用和满意度分析——基于两次卫生服务调查的比较[J].中国社会医学杂志,2023,40(6):737-741.
[18] 隋洪旭.内蒙古地区居民公共医疗卫生服务获得感实证研究[J].中国初级卫生保健,2023,37(11):15-18.
[19] 雷咸胜.中国居民医疗服务满意度研究——基于中国综合社会调查(Cgss)2015数据的实证分析[J].中国卫生政策研究,2019,12(3):1-7.
[20] 安东尼·吉登斯.社会的构成——结构化理论纲要[M].北京:中国人民大学出版社,2016.
[21] 李月娥,卢 珊.医疗卫生领域安德森模型的发展、应用及启示[J].中国卫生政策研究,2017,10(11):77-82.
[22] ZHAO D,ZHAO H,CLEARY PD.Understanding The Deter-minants of Public Trust in The Health Care System in China:An Analysis of A Cross-Sectional Survey[J].Journal of Health Services Research & Policy, 2019,24(1):37-43.
[23] 何 方.优质医疗资源配置与“看病难”[J].中国卫生产业,2018,15(29):16-18.
[24] 王荣华,王素平.全科医生在我国医疗卫生服务体系中的作用研究[J].中国全科医学,2020,23(4):388-394,402.
[25] 孙盼盼,夏 云.医务人员视角下的医患关系影响因素研究[J].中国医院管理,2016,36(12):63-65.
[26] 陶建平,吴汉辉,刘福星,等.共同富裕背景下农村居民医保受益公平性研究[J].社会政策研究,2022(3):61-78.
[27] 胡善联.用法律保护医疗卫生人员、促进和谐医患关系[J].卫生软科学,2020,34(3):3-6.
[28] 雷咸胜.我国医保基金监管现存问题与对策[J].中国卫生经济,2019,38(8):31-33.
[29] 汪新建,刘 颖.互联网使用行为对医患信任的影响:基于CFPS2016的分析[J].西北师范大学报(社会科学版),2019,56(2):119-126.
{{custom_fnGroup.title_cn}}
脚注
{{custom_fn.content}}
基金
国家自然科学基金资助项目(82173636);中央高校基本科研业务专项资金资助(2024-JYB-PY-004)
{{custom_fund}}