通讯作者: 姚强, yaoqiangblood@126.com

DOI：10.12201/bmr.202407.00015

Subjective Measurement of Health System Performance and Influencing Factors in the Context of High-Quality Development - An Empirical Study Based on CSS Survey From 2015 to 2021

• 摘要：高质量发展背景下从主观角度测度卫生系统绩效及其影响因素。利用2015-2021年中国社会状况综合调查数据（Chinese Social Survey，CSS），基于卫生系统绩效评估框架，从居民获得感视角构建卫生系统绩效指数，通过多层回归模型分析我国卫生系统绩效变化趋势及影响因素。我国卫生系统绩效综合指数从2015年的41.732提高到2021年的46.935，增长了12.47%（β=6.143, P<0.01）。其中，过程指数从43.961提高到45.968，增长了4.57%（β=2.391, P<0.01），结果指数从48.501提高到58.009，增长了19.60%（β=11.504, P<0.01）。卫生系统绩效获得感呈现出明显的异质性，性别、年龄、受教育程度、婚姻状况、就业状况、经济状况、医保类型和居住地区类型等因素显著影响居民卫生系统绩效的获得感。高质量发展背景下我国卫生系统绩效明显改善，居民获得感显著提高。然而，卫生系统过程维度改善相对有限，“看病难，看病贵”问题依然严峻。需重点加强脆弱人群以及农村地区卫生系统绩效获得感。

  关键词： 卫生系统; 绩效评估; 获得感; 影响因素; 中国

   

  Abstract: Health system performance and its influencing factors are measured from a subjective perspective in the context of high-quality development. Using data from the Chinese Social Survey from 2015 to 2021, this study constructed a health system performance index from the perspective of the sense of access of the population and analyzed the change trends and influencing factors of Chinas health system performance through a multilayer regression model. The results showed that the comprehensive index of health system performance in China increased by 12.47% (β=6.143, P<0.01) from 41.732 in 2015 to 46.935 in 2021, of which the process index increased by 4.57% (β=2.391, P<0.01) from 43.961 to 45.968, and the outcome index increased from 48.501 to 58.009, an increase of 19.60% (β=11.504, P<0.01). Meanwhile, the sense of access to health system performance showed obvious heterogeneity, with factors such as gender, age, education, marital status, employment status, economic status, type of health insurance and type of area of residence significantly affecting the sense of access to health system performance of residents. The health system performance in China in the context of high-quality development has significantly improved, and the sense of access of residents has significantly increased. However, the improvement in the process dimension of the health system is relatively limited, and difficult and expensive to see a doctor remains serious. It’s necessary to strength the health system performance of vulnerable groups, as well as rural areas.

  Key words: health system; performance assessment; sense of achievement; influencing factors; China

  提交时间：2024-07-10

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2024-03-03	bmr.202407.00015V1	下载

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