中国的分层诊断和治疗系统与移民使用基本公共卫生服务之间的关联
1School of Economics, Shandong Technology and Business University, Yantai, Shandong, China. jiahw_riem@foxmail.com.
BMC health services research
|December 6, 2025
概括
中国的分层诊断和治疗系统 (TDTS) 改革改善了移民获得基本公共卫生服务 (BPHS) 的机会. 在这一群体中,TDTS试点区域增加了健康记录的建立和家庭医生注册.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
背景情况:
- 中国的移民人口面临的障碍是由于Hukou系统而无法获得基本公共卫生服务 (BPHSs).
- 阶层诊断和治疗系统 (TDTS) 实施,以加强获得初级保健的机会.
- 这项研究调查了TDTS试点对移民中BPHS利用的影响.
研究的目的:
- 检查中国移民人口中接触分层诊断和治疗系统 (TDTS) 飞行员和基本公共卫生服务 (BPHSs) 的使用之间的关联.
- 评估初级医疗保健改革对弱势群体健康平等的影响.
- 确定影响国内移民获得BPHS的因素.
主要方法:
- 使用2018年中国移民动态调查数据进行的横截面研究 (N=132,598).
- 多变量线性概率模型评估了TDTS试点城市居住与建立健康记录 (EHR) 或向家庭医生注册 (RFD) 之间的关联.
- 倾向性得分匹配和安慰剂试验确保了研究结果的稳定性,控制共变量和固定效应.
主要成果:
- 居住在TDTS试点地区显著增加了建立EHR的概率6.6% (p<0.05) 和在RFD注册的概率4.9% (p<0.01).
- 这些代表了相对比基线利率的相对增加,分别为23.7%和40.2%.
- 对于女性和老年移民来说,正面关联更为明显,不论他们的教育程度或Hukou类型.
结论:
- 在移民中,分层诊断和治疗系统 (TDTS) 和基本公共卫生服务 (BPHS) 使用之间存在显著的积极关联.
- 加强初级医疗保健系统是克服弱势群体进入障碍的可行策略.
- 在中国复杂的制度框架内,TDTS改革显示出改善健康公平的前景.
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