上海市居民住院服务利用的影响因素

目的：分析上海市常住居民住院医疗服务利用的影响因素，为制订有关的卫生政策提供证据参考。 方法：数据来源于第5次国家卫生服务调查，基于Andersen模型框架选择自变量，采用两部模型分析上海市居民住院 率及住院费用的影响因素。结果：2013年上海市18岁以上常住居民的住院率为6.1%，住院人群的住院费用的平均水平 (中位数)为10 000.00元；性别、年龄、文化程度、婚姻、吸烟、饮酒、锻炼、交通时间、家庭年收入、恩格尔系数、 慢性病个数等是居民住院率的影响因素；性别、年龄、吸烟、饮酒、锻炼、恩格尔系数、医疗救助、住院机构级别 等因素可影响居民的住院费用。结论：上海市常住居民的住院服务利用受多种因素影响，应该针对不同人群制定相应 的卫生政策。

Influential factors of inpatient care among residents in Shanghai

Objective: To analyze the infl uential factors for inpatient care among residents in Shanghai and to provide evidence for health policy. Methods: Data were obtained from the Fifth National Health Services Survey, the independent variables were selected based on the framework of Andersen Model, and the two models were used to analyze the determinants-relevant hospitalization probability and the cost among residents in Shanghai. Results: The hospitalization rate among permanent residents over 18 years old was 6.1% in 2013 in Shanghai. For the hospitalized population, its average expenses (median) were 10 000.00 yuan. Gender, age, education, marriage, smoking, drinking, exercise, the travel time, family annual income, Engel coefficient and the number of chronic diseases were the determinants of hospitalization probability. Gender, age, smoking, drinking, exercise, Engel coefficient, medicaid and level of medical institution were the influential factors for the hospitalization costs. Conclusion: The utilization of inpatient care among residents in Shanghai is determined by many factors. Thus, the corresponding health policies should be formulated for different populations.