中国患者就医行为的影响因素：一项Meta分析
Influencing factors of patients' behavior of healthcare seeking: a meta-analysis in China.
作者信息
Song Yongtao, Wu Mingzhe, Feng Hailong
机构信息
School of Business, Henan University, Kaifeng, China.
School of Business Administration, Anhui University of Finance and Economics, Bengbu, China.
出版信息
Front Public Health. 2025 Apr 28;13:1583075. doi: 10.3389/fpubh.2025.1583075. eCollection 2025.
OBJECTIVES
Understanding patient's healthcare seeking behavior (BHS) and identifying the determinants influencing BHS can optimize the allocation of medical resources and enhance the efficacy of healthcare systems. The purpose of this study is to identify the influencing factors of patients' BHS and to assess the extent and variation in their impact on BHS.
METHODS
Drawing upon the Anderson Behavioral Model of Health Service Utilization, we summarized the factors influencing patients' BHS into three categories, and examined empirical journal articles published from 2010 to 2023 using meta-analysis. In addition, the Bayesian analysis of variance was introduced to explore the influence of moderators.
RESULTS
A total of 39 empirical journal articles were finally identified for meta-analysis. Ten out of the thirteen factors have a significant and positive influence on BHS, with the exception of trust in medical institutions ( = 0.176, = 0.077), health record ( = 1.942, = 0.052), and medical expenses ( = 0.1846, = 0.065). The results of moderating effect analysis indicate that there is a significant difference in the impact of age ( < 0.001), education level ( < 0.05), family income ( < 0.001), medical insurance ( < 0.001), illness severity ( < 0.01), and healthcare service reputation ( < 0.001) on BHS.
CONCLUSION
There is a positive and significant influence of the antecedent variables (self-rated health, distance to medical facilities, illness severity, age, family income, education level, marital status, medical insurance, awareness of hierarchical healthcare, health record, and healthcare service reputation) on BHS. Furthermore, the influences of family income, medical insurance, and illness severity on BHS in developed areas are stronger than that in underdeveloped areas, while the influences of age, education level, and healthcare service reputation on BHS in underdeveloped areas are stronger than that in developed areas.
目的
了解患者的就医行为（BHS）并确定影响BHS的决定因素，可优化医疗资源分配并提高医疗系统的效率。本研究的目的是确定患者BHS的影响因素，并评估其对BHS影响的程度和差异。
方法
借鉴安德森卫生服务利用行为模型，我们将影响患者BHS的因素归纳为三类，并使用荟萃分析研究了2010年至2023年发表的实证期刊文章。此外，引入贝叶斯方差分析以探讨调节因素的影响。
结果
最终确定了39篇实证期刊文章用于荟萃分析。除了对医疗机构的信任（β = 0.176，p = 0.077）、健康记录（β = 1.942，p = 0.052）和医疗费用（β = 0.1846，p = 0.065）外，十三个因素中的十个对BHS有显著的正向影响。调节效应分析结果表明，年龄（p < 0.001）、教育水平（p < 0.05）、家庭收入（p < 0.001）、医疗保险（p < 0.001）、疾病严重程度（p < 0.01）和医疗服务声誉（p < 0.001）对BHS的影响存在显著差异。
结论
先行变量（自评健康、到医疗机构的距离、疾病严重程度、年龄、家庭收入、教育水平、婚姻状况、医疗保险、分级医疗意识、健康记录和医疗服务声誉）对BHS有正向且显著的影响。此外，家庭收入、医疗保险和疾病严重程度对发达地区BHS的影响强于欠发达地区，而年龄、教育水平和医疗服务声誉对欠发达地区BHS的影响强于发达地区。
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