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探讨中国普通公众的医疗决策模式和影响因素:二元逻辑回归分析。

Exploring the medical decision-making patterns and influencing factors among the general Chinese public: a binary logistic regression analysis.

机构信息

Institute of Humanities and Social Sciences, Guangzhou Medical University, Guangzhou, 511436, China.

School of Health Management, Guangzhou Medical University, Guangzhou, 511436, China.

出版信息

BMC Public Health. 2024 Mar 25;24(1):887. doi: 10.1186/s12889-024-18338-8.

Abstract

OBJECTIVE

With the ongoing evolution of the healthcare system and shifts in cultural paradigms, there is a pressing need to delve into the medical decision-making behaviors of general Chinese public and understand their underlying motivations. This research seeks to elucidate the prevailing tendencies in these decision-making processes and to empirically validate the pivotal factors that shape their choices, offering valuable insights for healthcare policymakers and institutions.

METHOD

A comprehensive survey was administered to 2,696 Chinese residents to examine their medical decision-making patterns. These patterns were classified into two primary categories: Unilateral Decision-making (Doctor-dominant, Family-centric, and Patient-driven subtypes) and Collaborative Decision-making (Doctor-led, Doctor-Patient, Patient-Family, and Doctor-Patient-Family subtypes). Binary logistic regression analysis was employed to empirically pinpoint the significant factors influencing these decision-making frameworks.

RESULTS

The study's analysis reveals distinct preferences in medical decision-making among Chinese residents. In the Collaborative Decision-making category, chosen by 70.81% of participants, the subtypes are as follows: Doctor-led (29.90%), Doctor-Patient (13.54%), Patient-Family (2.93%), and Doctor-Patient-Family (24.44%). The Unilateral Decision-making, preferred by 29.19%, includes Doctor-dominant (23.22%), Family-centric (1.74%), and Patient-driven (4.23%) models. The preference for Collaborative Decision-making is associated with higher educational levels, specific marital statuses (particularly married but childless), and choices of rural residents' basic medical insurance or occupational basic medical insurance. In contrast, Unilateral Decision-making correlates with males, individuals with religious beliefs, certain occupational roles (like civil servants), and holders of commercial or publicly funded medical insurance.

CONCLUSION

This study elucidates the complex interplay of socio-cultural and individual determinants shaping medical decision-making in China. The findings reveal a marked inclination towards collaborative models, closely linked to educational level, marital status, and specific insurance types, reflecting an evolving trend towards participatory healthcare. Simultaneously, the persistence of unilateral models, influenced by gender, religious beliefs, and occupational roles, highlights the heterogeneity within Chinese healthcare preferences. These insights are crucial for policymakers and healthcare practitioners, underscoring the need for adaptable, culturally attuned healthcare frameworks that cater to this diversity, thereby enhancing patient engagement and healthcare efficacy.

摘要

目的

随着医疗体系的不断发展和文化观念的转变,深入研究普通中国公众的医疗决策行为并了解其背后的动机迫在眉睫。本研究旨在阐明这些决策过程中的主流趋势,并从实证角度验证影响决策选择的关键因素,为医疗保健政策制定者和机构提供有价值的见解。

方法

对 2696 名中国居民进行了一项全面调查,以研究他们的医疗决策模式。这些模式分为两类:单边决策(医生主导、家庭为中心和患者驱动的亚型)和协作决策(医生主导、医患、患者-家庭和医患-家庭的亚型)。采用二元逻辑回归分析实证确定影响这些决策框架的显著因素。

结果

研究分析揭示了中国居民在医疗决策方面的明显偏好。在协作决策类别中,有 70.81%的参与者选择,其中包括以下亚型:医生主导(29.90%)、医患(13.54%)、患者-家庭(2.93%)和医患-家庭(24.44%)。29.19%的参与者更喜欢单边决策,包括医生主导(23.22%)、家庭为中心(1.74%)和患者驱动(4.23%)模式。选择协作决策与较高的教育水平、特定的婚姻状况(特别是已婚但无子女)以及农村居民选择基本医疗保险或职业基本医疗保险有关。相比之下,单边决策与男性、有宗教信仰的个体、特定职业角色(如公务员)以及持有商业或公共医疗保险的个体相关。

结论

本研究阐明了影响中国医疗决策的社会文化和个体决定因素的复杂相互作用。研究结果表明,人们明显倾向于协作模式,这种模式与教育水平、婚姻状况和特定保险类型密切相关,反映了参与式医疗保健的发展趋势。同时,单边模式的持续存在,受性别、宗教信仰和职业角色的影响,突出了中国医疗保健偏好的异质性。这些见解对政策制定者和医疗保健从业者至关重要,强调需要适应文化的医疗保健框架,以满足这种多样性,从而提高患者参与度和医疗保健效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e38/10962172/a8e9efbf4ff0/12889_2024_18338_Fig1_HTML.jpg

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