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中国北方农村慢性病患者对同一医院再次选择的农村医疗保险效应。

Effects of Rural Medical Insurance on Chronically Ill Patients' Choice of the Same Hospital Again in Rural Northern China.

机构信息

School of Business, Central South University, Changsha 410083, Hunan, China.

Manchester Institute of Innovation Research, Alliance Manchester Business School, The University of Manchester, Manchester M13 9PL, UK.

出版信息

Int J Environ Res Public Health. 2018 Apr 12;15(4):731. doi: 10.3390/ijerph15040731.

Abstract

The emergence of rural health insurance plays a crucial role in alleviating the pressure on rural medical expenditure. Under the current medical system in northern China, rural medical insurance may reduce the free referral of patients with chronic diseases among hospitals. This study was carried out based on the results of an investigation of rural chronically-ill patients in eight county hospitals in northern China, as well as through the comparison and analysis of patients with chronic diseases, considering whether they were with or without rural health insurance. The main results showed that both age (2 = 22.9, < 0.000) and income level (2 = 18.5, < 0.000) had considerable impact on the rural peoples' willingness to buy health insurance. Meanwhile, both the quality of the hospital's treatment ( = 0.555, < 0.000), and service quality ( = 0.168, < 0.000) had a significant positive correlation with the likelihood of a given patient choosing the same hospital on the next visit, but the medical costs had a significant negative correlation ( = -0.137, < 0.000). Eventually, it was found that the provision of rural health insurance had weakened the three relationships upon which the aforementioned correlations were based.

摘要

农村医疗保险的出现对缓解农村医疗支出压力起到了至关重要的作用。在中国北方现行的医疗体制下,农村医疗保险可能会减少慢性病患者在医院之间的自由转诊。本研究基于对中国北方 8 家县级医院的农村慢性病患者的调查结果,通过对慢性病患者是否有农村医疗保险的比较和分析,考虑了他们的年龄(2 = 22.9,<0.000)和收入水平(2 = 18.5,<0.000)对农村居民购买医疗保险意愿的影响。同时,医院的治疗质量(= 0.555,<0.000)和服务质量(= 0.168,<0.000)与患者下次就诊时选择同一医院的可能性呈显著正相关,但医疗费用呈显著负相关(= -0.137,<0.000)。最终发现,农村医疗保险的提供削弱了上述相关性所依据的三个关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0096/5923773/57566ba0b859/ijerph-15-00731-g001.jpg

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