探索患者的意图从医院转移到初级保健机构进行初级保健:一个推拉泊框架
Jingrong Zhu1, Maoxing Liu2, Muyang Zhang1
1School of Economics and Management, Communication University of China, Beijing 100024, China.
Australian journal of primary health
|June 23, 2025
概括
患者更有可能转向初级保健全科医生 (GPs),当不满意的医院 (推) 和吸引到GP系统 (拉). 然而,根深蒂固的习惯和不信任 (挂) 阻碍了这种转变,需要有针对性的干预.
科学领域:
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
- 行为经济学是一种行为经济学.
背景情况:
- 中国的分层医疗保健系统鼓励使用初级保健,但缺乏强制性门卫.
- 患者经常绕过初级保健机构 (PCI) 进入更高级别的医院.
- 对于驱使患者转向PCI中的全科医生 (GPs) 的因素的了解有限.
研究的目的:
- 分析影响患者从更高层次机构转移到PCI中的全科医生的意图的因素.
- 应用推拉挂 (PPM) 框架来理解寻求医疗保健的行为.
- 确定中国采用初级保健的关键驱动因素和障碍.
主要方法:
- 使用推拉挂 (PPM) 框架来概念化切换意图.
- 收集了来自中国612名受访者关于寻求医疗保健行为的数据.
- 采用部分最小平方-结构方程建模 (PLS-SEM) 来测试假设.
主要成果:
- 对医院服务的不满 (推动因素) 对转换意图产生积极影响.
- 医生系统的吸引力 (吸引因素) 也对转换意图产生积极影响.
- 根深蒂固的医院习惯和对全科医生的不信任 (系因素) 会对切换行为和适度的推拉效应产生负面影响.
结论:
- 解决患者不满和增强GP系统的吸引力对于促进初级保健利用至关重要.
- 缓解根深蒂固的习惯和对全科医生的不信任对于克服切换障碍至关重要.
- 政策干预应侧重于提高GP的吸引力,并建立患者对初级保健服务的信任.
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