He Lei, Gao Bo, Ren Xiao-Hui, Chai Qi, Zhou Zhao-Fei
Department of Health Behavioral and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2022 Mar;53(2):310-315. doi: 10.12182/20220360107.
To explore the influence of social capital on the local residents' choice of medical institutions and to provide a reference basis for promoting diagnosis and treatment services available at different tiers.
A classification tree model was established using the exhaustive chi-square automatic interaction detection (Exhaustive CHAID) method to screen for factors influencing the residents' choice of medical institutions, and a logistic regression model was used to quantitatively analyze the interaction effect of the influencing factors.
The classification tree model showed that there were four layers and eight terminal nodes, identifying a total of six influencing factors, including individual social capital, self-reported physical health, education, community social capital, chronic disease prevalence, and self-reported mental health. Logistic regression analysis showed that education (odds ratio []=0.660, 95% confidence interval []: 0.502-0.869), community social capital (=0.746, 95% : 0.589-0.943), and individual social capital (=0.405, 95% : 0.287-0.572) (<0.001) had an impact on residents' choice of medical institution. There was an interaction between individual social capital and self-reported physical health on residents' choice of medical institution (=1.872, 95% : 1.180-2.969, <0.05).
Interventions in terms of social capital factors should be considered in order to promote the rational use of medical resources.
探讨社会资本对当地居民医疗机构选择的影响,为促进不同层级诊疗服务提供参考依据。
采用穷尽式卡方自动交互检测(Exhaustive CHAID)方法建立分类树模型,筛选影响居民医疗机构选择的因素,并采用逻辑回归模型定量分析影响因素的交互作用。
分类树模型显示有四层和八个终端节点,共识别出六个影响因素,包括个体社会资本、自评身体健康状况、教育程度、社区社会资本、慢性病患病率和自评心理健康状况。逻辑回归分析显示,教育程度(比值比[]=0.660,95%置信区间[]:0.502-0.869)、社区社会资本(=0.746,95%:0.589-0.943)和个体社会资本(=0.405,95%:0.287-0.572)(<0.001)对居民医疗机构选择有影响。个体社会资本与自评身体健康状况在居民医疗机构选择上存在交互作用(=1.872,95%:1.180-2.969,<0.05)。
应考虑对社会资本因素进行干预,以促进医疗资源的合理利用。