通讯作者: 马东平, anqiuma123@163.com

DOI：10.12201/bmr.202412.00002

Family doctors of chronic disease comorbid patients based on discrete choice experimentresearch on preference of contract service selection

• 摘要：摘要 目的 分析慢性病共病患者家庭医生签约服务选择偏好，为推动家庭医生签约服务高质量发展提供理论借鉴。 方法 基于离散选择实验进行问卷设计，对通过一致性检验的768份合格样本利用混合logit模型、支付意愿法等进行分析。 结果 在纳入研究的所有服务属性中，慢性病共病患者更愿意选择服务费用低，提供医疗服务、西医服务、2周慢性病长处方、专业药师用药指导、门诊就诊的家庭医生签约服务；服务费用的属性相对重要性占比最大（41.42%），其次是服务类型（26.25%）；若服务类型由中医转为西医，慢性病共病患者愿意多花费120.418元，选择偏好增加44.80%；不同性别、年龄段的共病患者选择偏好存在异质性。 结论 未来需根据地区发展差异和患者选择偏好合理制定服务费用收费标准，同时需推动基层中医服务发展和标准化建设，发挥中医在“治未病”和慢性病防治中的独特优势。促进家庭医生团队合理化建设，加强家庭医生用药指导能力，满足患者多样化服务需求。明确不同特征患者选择偏好差异，重点关注老年慢病共病患者。通过政府、基层医疗卫生机构、家庭医生等多方共同参与推动家庭医生签约服务高质量发展。

  关键词： 离散选择实验；慢性病共病；家庭医生签约服务；选择偏好; ; ; 

   

  Abstract: Abstract Objective To analyze the preference of family doctors for contracting services for patients with chronic disease comorbidities, and to provide theoretical reference for promoting the high-quality development of family doctors contracting services. Methods Based on discrete selection experiment, 768 qualified samples that passed the consistency test were analyzed by mixed logit model and willingness to pay method. Results Among all the service attributes included in the study, the patients with chronic diseases were more willing to choose the family doctor contract service with low service cost, providing medical service, Western medicine service, 2-week prescription for chronic disease, professional pharmacist medication guidance, and outpatient treatment. The relative importance of the attribute of service cost is the largest (41.42%), followed by the type of service (26.25%). If the service type changed from Chinese medicine to Western medicine, the patients with chronic diseases were willing to spend 120.418 yuan more, and the choice preference increased by 44.80%; There was heterogeneity in the selection preferences of comorbid patients of different genders and ages. Conclusion In the future, it is necessary to reasonably formulate service fee standards according to regional development differences and patients choice preferences, and promote the development and standardization of TCM services at the grass-roots level, so as to give full play to the unique advantages of TCM in the treatment of disease and chronic disease prevention and treatment. Promote the rationalization of family doctor team construction, strengthen the ability of family doctors to guide medication, and meet the diversified service needs of patients. The selection preference of patients with different characteristics was clarified, focusing on the elderly chronic disease comorbid patients. Through the government, grass-roots medical and health institutions, family doctors and other parties to jointly participate in promoting the high-quality development of family doctor contracted services.

  Key words: Discrete choice experiment; Chronic disease comorbidity; Contracted services of family doctors; Selection preference

  提交时间：2024-12-02

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• 序号	提交日期	编号	操作
  1	2024-09-09	bmr.202412.00002V1	下载

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