吕艳霞　胡盟　徐爱军

中圖分类号 R288 文献标志码 A 文章编号 1001-0408（2021）21-2668-05

DOI 10.6039/j.issn.1001-0408.2021.21.18

摘 要 目的：探讨江苏省门诊患者利用中医药服务行为的影响因素，为中医药服务的科学利用提供参考。方法：基于2018年《全国第六次卫生服务统计调查报告》中江苏省的相关数据，描述性分析江苏省1 617例门诊患者利用中医药服务的一般情况及人群特征，采用单因素分析和多因素二元Logistic回归模型分析该省门诊患者利用中医药服务行为的影响因素。结果：在1 617例调查对象中，有145例患者（9.0%）在门诊就诊时利用了中医药服务。单因素分析结果显示，年龄、文化程度、年收入、是否参加基本医疗保险、自觉伤病严重程度、是否有高血压、是否有糖尿病、是否有其他慢性病、首诊医疗机构均为江苏省门诊患者利用中医药服务行为的显著影响因素（P<0.05）。二元Logistic回归结果显示，65岁及以上、参加城镇职工基本医疗保险、患有高血压、首诊为基层医疗机构、中等收入、患有其他慢性病等变量为江苏省门诊患者利用中医药服务行为的显著影响因素（P<0.05）。结论：年龄、年收入、是否参加基本医疗保险、是否患有高血压或其他慢性病以及首诊医疗机构是江苏省门诊患者利用中医药服务行为的显著影响因素。江苏省门诊患者利用中医药服务的水平相对较低，中老年患者和慢性病患者对中医药服务的接受度较高，首诊在基层医疗机构的门诊患者更愿意接受中医药服务。

关键词 中医药服务;影响因素;门诊患者;Logistic回归模型;江苏省

ABSTRACT   OBJECTIVE： To investigate the influential factors of traditional Chinese medicine （TCM） service utilized by outpatients in Jiangsu province， and to provide reference for scientific utilization of TCM service. METHODS： Based on the data of Jiangsu province in National Sixth Health Service Survey in 2018， descriptive analysis was performed for the general situation and population characteristics of 1 617 outpatients in Jiangsu province. Single factor analysis and multivariate binary Logistic regression model analysis were used to analyze the influential factors of TCM service utilized by outpatients. RESULTS： Of the 1 617 respondents， 145 patients （9.0%） applied TCM services at outpatient visits. Results of single factor analysis showed that age， education degree， annual income， whether to participate in basic medical insurance， self-perceived illness severity， hypertension， diabetes， other chronic diseases， and the first diagnose institutions were significant influential factors for TCM service utilized by outpatients in Jiangsu province （P<0.05）. Results of binary Logistic regression showed that the elderly aged 65 years and over， the patients who participated in the basic medical insurance for urban workers， the patients with hypertension， primary medical institutions as first diagnosis institutions， the middle-income population， and other chronic diseases were significant influential factors for TCM service utilized by outpatients in Jiangsu province （P<0.05）. CONCLUSIONS： Age， annual income， whether to participate in basic medical insurance， hypertension and other chronic diseases， and first diagnosis institutions are significant infleutial factors for TCM service utilized by outpatients in Jiangsu province. The utilization of TCM health services for outpatients in Jiangsu province is in relatively low level， and middle-aged and elderly patients and patients with chronic diseases show high acceptance for TCM services. Outpatients first diagnosed in primary medical institutions are more willing to accept TCM services.

KEYWORDS   Traditional Chinese medicine service; Influential factors; Outpatients; Logistic regression model; Jiangsu province

进入21世纪后，全球人口老龄化和慢性病逐渐成为人群主要疾病负担的来源[1]，人们对包括中医药在内的补充和替代医学[complementary and alternative medicine（CAM），此概念由美国国立研究院提出，指美国主流医学（常规医学）之外的医疗保健实践，以缓解和改善临床症状为主要目的]的利用不断增加[2]。如今，中医药已传播到全球183个国家和地区[3]，有60%的日本、韩国和新加坡人，40%的美国成人，10%的英国人，30%～50%的瑞士人和60%～70%的澳大利亚人每年至少利用1次包括中医药在内的CAM进行治疗[1]。其治疗病种包括肌肉骨骼疼痛、妊娠和绝经诸症、肠胃病、精神疾病、癌症[4-5] ;且从利用人群特征看，以中年、女性、更高教育水平、较高收入者居多[4-5]。……