北京市城乡居民口腔卫生服务利用与费用模型的研究

目的 建立北京市城乡居民口腔卫生服务利用预测模型，进行精确性研究，为开展口腔医疗保险提供依据。方法 采用分层、整群、随机抽样方法，抽取城乡居民共3395人进行调查，利用Logistic回归拟合就诊概率模型；利用对数线性回归拟合利用者的就诊频率和费用模型。利用平均预测偏差、预测残差均方和相对预测偏差进行模型预测效果评价。结果 城乡居民口腔卫生服务利用三部模型拟合较好，就诊概率模型的调整决定系数较高．城乡分别为0．621和0．642，而就诊频率和费用的调整决定系数较低。就诊概率模型预测精确度分别为城区83．7％，农村89．6％。就诊频率和费用相对预测偏差为8．85％～14．10％。结论 分解模型法是建立口腔卫生服务利用预测模型的较好方法，预测准确性较高，通过对数转换可改善资料的偏态性。预测模型可用来进行影响因素分析和保险基金与保险因子的测算。

A study on the model of dental care utilization and expenditure of residents in Beijing

Objective To establish a prediction model of dental care utilization of residents in Beijing, to evaluate the model accuracy, and to provide a basis for the development of an oral health insurance system.Methods A total of 3395 subjects was selected by stratified, clustering, and random sampling. Logistic regression method was used to establish a probability prediction model. Loglinear regression method was used to evaluate the frequency and expenditure models. MFB, MSFE and P.E% were calculated to evaluate the model accuracy.Results The skewness of the data was modified by logarithmic transformation. The three-part model of dental utilization fit well. The adjusted R2 of the probability model was high, the value was 0.621 for the urban area and 0.642 for the rural area, respectively. The adjusted R2 of the frequency and expenditure model was lower. The prediction ratings of probability model were 83.7% for the urban area and ~89.6% for the rural area. The P.E% of frequency and expenditure model ranged from ~8.85% to ~14.10% .Conclusion The three part model method was effective in establishing a prediction model of dental care utilization with a reliable prediction capacity. The predicted model established in this study can be used to analyze the affecting factors on dental care utilization and to calculate the insurance funds and other factors.