基于主成分分析的中医药基本医疗保障体系中遴选影响因素的调查分析

目的:为优化、完善中医药基本医疗保障体系中中医药的遴选提供参考。方法:设计"中医药基本医疗保险目录和基本药物目录遴选指标体系构建调查问卷",包括专家的基本情况、Likert量表、2道开放式问题,对中国中医药临床专家进行问卷调查,运用SPSS 16.0进行因子分析,提取主成分公因子以确定中医药遴选的影响因素,同时构建公因子的决策模型。结果与结论:共发放调查问卷429份,回收有效问卷137份,回收有效率为31.93%。问卷具有较好的内部一致性(ICC=0.745),KMO及Bartlett球形度检验的结果为0.714,通过主成分分析,8个公因子被提炼出来,累计贡献率为70.923%。分析结果提示,中医药遴选中需要重点关注的要素包括患者的主观感受、临床长期的治疗效果、生命质量量表的选择、中医药与西医药的替代性、药物经济学的评价结果、患者整体精气神的改善以及患者全部的经济负担、中医药的副作用。

Investigation and Analysis of Influential Factors for the Selection of Traditional Chinese Medicine in Health Care System Based on Main Component Analysis

OBJECTIVE： To promote reference for the improvement of the selection mechanism of TCM health care System. METHODS： A questionnaire survey was conducted among TCM practitioners and researchers who had clinical experience in China, to determine the influencing factors of TCM selection we should pay attention to and establish decision model of TCM selec- tion. A questionnaire about Selection Index System Construction of TCM Health Care Insurance List and Essential Drugs List （with 2 open-end questions at Likert 7-levels） was designed, including general information of specialists. The factor analysis was conduct- ed using SPSS 16.0 software, and the common factors of main components were extracted to determine influential factors of TCM selection and establish decision model of common factors. RESULTS ＆ CONCLUSIONS： Of 429 questionnaires, 137 were re- turned from respondents with recovery rate of 31.93%. Internal consistency coefficients was obtained （ICC=0.745）, indicating good reliability of this measurement scale passed the KMO test and Bartlett＇ s test of sphericity （kmo=0.714）. In addition, 8 com- mon factors were extracted after main component analysis with accumulative variance of 70.923%. Our findings suggest that factors should be considered during the selection of TCM, including patient preference, long-term outcomes, the choice of the scale of life quality, comparative study of alternative options between TCM and western medicine, pharmacoeconomic evaluation results, the overall improvement of patients and overall economic burden of patients and side effects of TCM.