我国卫生资源配置对不同收入居民住院就医行为的影响

目的:分析医疗卫生资源配置对不同收入居民住院服务就医行为的影响。方法:将2008年和2013年国家卫生服务调查的个体数据和样本县/区的医疗卫生资源数据对接,分别采用两水平零膨胀负二项回归和两水平多项logit模型分析卫生资源配置对居民住院服务利用行为和住院机构选择行为的影响。结果:乡镇卫生院/社区卫生服务中心千人口床位数和县/区医院千人口执业医师数的增加可提高县域内住院服务利用;基层医疗卫生资源的投入对提高低收入群体在县域内住院的作用大于高收入群体。结论:基层医疗卫生资源的投入对于改善低收入群体的住院就医行为发挥重要作用。

Impact of health resources allocation on healthcare seeking behavior among inpatients in China

Objective: This study aims at exploring the impact of the health resources allocation on healthcare seeking behavior of inpatients with different income in China. Methods: Data at individual level were collected from China National Health Service Surveys conducted in 2008 and 2013, interlinked with the data of health resources in county level. Multilevel zero-inflated negative binomial regression and multilevel multinomial logit model were respectively used to examine the impact of the health resources allocation on inpatient visits and the influence of the choice of healthcare providers by inpatients. Results: The results show that the increase of the number of beds in primary health centers (PHCs) and physicians in county hospitals increased inpatient visits within counties. The investments in health resources in PHCs had greater impact on improving the likelihood of inpatient visits within counties for the low-income populations than that for the high-income populations. Conclusion: Investments in health resources in PHCs are vital to improve the healthcare seeking behaviors of the low-income populations in China.