河南省卫生系统反应性影响因素多水平模型分析

目的 探讨河南省卫生系统反应性的主要影响因素.方法 采用多阶段分层整群随机抽样方法,在河南省16个城市抽取年满18周岁居民3 000人进行问卷调查,对其中在过去12个月中接受过医疗机构服务,且完成卫生系统反应性问卷调查的1 311人的卫生系统反应性评分进行因子分析,以调查个体为水平1,以不同地区为水平2,采用二水平方差成分模型分析卫生系统反应性影响因素.结果 卫生系统反应性存在地区聚集性(2χ=5.76,P=0.016);年龄较大(60~69岁)、饮酒频率越高、参与社会活动有轻度困难、拥有门诊保险的人群对卫生系统反应性评价较低,回归系数β分别为0.231、0.086、0.119、0.488,Wald检验P<0.05.结论 河南省卫生系统反应性的影响因素主要是地区差异以及弱势人群;应用二水平方差成分模型可准确估计其影响因素.

Multilevel model for influencing factors of health system responsiveness in Henan province

Objective To investigate the influencing factors of health system responsiveness in Henan province.Methods By multi-stage stratified cluster random sampling technique,3 000 residents aged over 18 years were sampled from 16 cities of Henan province,of which,1 311 residents who received service in medical clinics during past 12 months and fulfilled a questionnaire on health system responsiveness were investigated.Scores of health system responsiveness were calculated with factor analysis.Two level variance co...