Yu Mingming, Zhao Guoyang, Tang Dan
Department of Economics and Management Shanghai Technical Institute of Electronics and Information Shanghai China.
Department of Economics and Management Tongji Zhejiang College Jiaxing China.
Health Sci Rep. 2022 Sep 11;5(5):e821. doi: 10.1002/hsr2.821. eCollection 2022 Sep.
Exploring the mechanism influencing the choice of hospital among patients is important to render better care to them. The main purpose of this study is to evaluate the relationship between outpatients' different internal factors (sociodemographic and psychological characteristics) and different external factors (provider characteristics) regarding their choice of hospital.
The data obtained via questionnaire was analyzed with a linear regression model to verify the relationship between outpatients' internal and external factors. In addition, for external factors, we built a score reflecting a comprehensive hospital's "hard power" (diagnosis and treatment technology and expertise, i.e., to say, the curative capability) and "soft power" (whether the environment for seeing a doctor is convenient and cheap, etc.) factors which influence the choice of outpatients, and the factors were given different points and weighted according to the option's order of the questionnaire.
We did not see evidence that internal factors such as gender, age, birthplace, and having or not having medical insurance had an effect on the comprehensive external factors of the hospital's choice ( > 0.05). However, statistically significant differences were found ( < 0.001) that outpatients who usually resided near Jiaxing valued hospitals' "hard power" to a greater extent than did outpatients who lived in Jiaxing city, otherwise, "soft power" was prioritized. Similarly, outpatients who recognized themselves as having serious diseases valued hospitals' "hard power" to a greater extent than those with moderate or minor diseases, otherwise, "soft power" was prioritized ( = 0.03).
By enhancing the hospital's "soft power," the managers of small hospitals could attract different outpatients from large hospitals, such as outpatients with minor or moderate diseases. Moreover, the regional health service organizations should promote the building of first- and second-level hospitals near cities to retain more outpatients and to achieve outpatients' diversion from large tertiary hospitals.
探究影响患者医院选择的机制对于为其提供更好的医疗服务至关重要。本研究的主要目的是评估门诊患者不同的内部因素（社会人口统计学和心理特征）与不同的外部因素（医疗机构特征）之间关于其医院选择的关系。
通过问卷调查获得的数据采用线性回归模型进行分析，以验证门诊患者内部和外部因素之间的关系。此外，对于外部因素，我们构建了一个反映综合医院“硬实力”（诊断和治疗技术及专业水平，即治疗能力）和“软实力”（看病环境是否便捷、费用是否低廉等）的得分，这些因素会影响门诊患者的选择，并且根据问卷选项顺序为这些因素赋予不同分值并加权。
我们没有发现证据表明性别、年龄、出生地以及是否拥有医疗保险等内部因素对医院选择的综合外部因素有影响（>0.05）。然而，发现了具有统计学意义的差异（<0.001），即通常居住在嘉兴附近的门诊患者比居住在嘉兴市的门诊患者更看重医院的“硬实力”，否则，“软实力”被优先考虑。同样，自认为患有严重疾病的门诊患者比患有中度或轻度疾病的患者更看重医院的“硬实力”，否则，“软实力”被优先考虑（=0.03）。
通过提升医院的“软实力”，小型医院的管理者可以吸引来自大型医院的不同门诊患者，例如患有轻度或中度疾病的门诊患者。此外，区域卫生服务组织应推动城市周边一级和二级医院的建设，以留住更多门诊患者，并实现门诊患者从大型三级医院的分流。
