Analysis of outpatient choice and its influencing factors of hypertensive patients with medical insurance in Beijing / 中华医院管理杂志

ABSTRACT

Objective:To investigate the current status and influencing factors of outpatient institution choice for hypertensive patients with basic medical insurance in Beijing, for reference to promote the implementation of the hierarchical medical system and guiding hypertensive patients to seek healthcare in primary care.Methods:Based on data of hypertensive outpatients from the basic medical insurance database of Beijing from April 2019 to January 2020, we analyzed major demographic characteristics of hypertensive patients, the selection of outpatient institutions and its influencing factors. The chi square test was used for comparison between groups, and the multivariate logistic regression model was used to analyze influencing factors.Results:2.842 1 million outpatients with hypertension were enrolled. 39.03% of them chose primary healthcare institutions, 5.16% chose secondary healthcare institutions, and 17.34% chose tertiary healthcare institutions, while the rest 38.47% chose two or more types of healthcare institutions. Gender, age, type of medical insurance, place of residence, utilization of Chinese herbal drugs, utilization of Chinese patent drugs, polypharmacy, needs of outpatient tests and examinations were the influencing factors for their selection of primary healthcare institutions for hypertensive outpatients under Beijing basic medical insurance.Conclusions:At present, the primary institutions have become the first choice for the majority of hypertensive patients with medical insurance in Beijing, but there are still many influencing factors on their choice of institutions. In the future, we should optimize the allocation of medical resources, promote the reform of medical insurance payment methods, strengthen the construction of primary medical institutions, expand the coverage of contracted services of family doctors, and reasonably guide the patients to seek healthcare in primary healthcare institutions.