Youjiang Medical University for Nationalities, Baise, China.
Peking University, Beijing, China.
PLoS One. 2020 Jun 3;15(6):e0234081. doi: 10.1371/journal.pone.0234081. eCollection 2020.
With the rapid economic development across China over recent decades, examining how urbanization may affect healthcare service use and its implications is more than urgent. This study estimates the association between urbanization and primary healthcare services use in China. We construct a prefecture-level dataset on healthcare services utilization and urbanization. We regress the proportion of residents using healthcare services in primary healthcare centers versus secondary or tertiary hospitals on a set of prefecture-level control variables. Results suggest that use of primary healthcare centers outpatient service is positively associated with being in the proximity of a provincial capital, but negatively correlated with the percentage of the urban population and the availability of public transportation. Higher likelihood of seeking care in major hospitals instead of primary healthcare centers is associated with urbanization, justifying a need for primary care physicians as gatekeepers in China's healthcare delivery system.
近几十年来，随着中国经济的快速发展，研究城市化如何影响医疗服务的利用及其影响已经刻不容缓。本研究估计了城市化与中国基本医疗服务利用之间的关系。我们构建了一个关于医疗服务利用和城市化的地级市数据集。我们根据一组地级市的控制变量，对居民在基层医疗机构和二级或三级医院使用医疗服务的比例进行回归。结果表明，使用基层医疗机构的门诊服务与接近省会城市呈正相关，但与城市人口比例和公共交通的可用性呈负相关。在大医院而不是基层医疗机构寻求医疗服务的可能性更高与城市化有关，这证明了在中国的医疗服务提供体系中，初级保健医生作为守门人是有必要的。
