CAJ | 학술논문

为了调查新农合制度下参合农民的就诊意向及其影响因素，首先对山东省66个县1278个农户进行入户问卷调查，发现超过九成的农户会选择基层医疗机构。然后采用嵌套Logit模型对农户就诊意向的影响因素进行检验，实证结果显示，在第一层次医疗机构（基层与高层）选择时，老年患者、慢性病患者和认为缴费水平过高的农户会倾向到基层定点医院就诊；农民受教育程度越高、报销次数越多、报销金额越高或者同时拥有商业保险者，越倾向到高层定点医疗机构就诊。在第二层次各级医疗机构选择时，平均花费和医疗服务质量高、报销比例高、距离近的医疗机构更受青睐，其中前两个因素的作用十分显著。
위료조사신농합제도하삼합농민적취진의향급기영향인소，수선대산동성66개현1278개농호진행입호문권조사，발현초과구성적농호회선택기층의료궤구。연후채용감투Logit모형대농호취진의향적영향인소진행검험，실증결과현시，재제일층차의료궤구（기층여고층）선택시，노년환자、만성병환자화인위격비수평과고적농호회경향도기층정점의원취진；농민수교육정도월고、보소차수월다、보소금액월고혹자동시옹유상업보험자，월경향도고층정점의료궤구취진。재제이층차각급의료궤구선택시，평균화비화의료복무질량고、보소비례고、거리근적의료궤구경수청래，기중전량개인소적작용십분현저。
In order to study enrolled farmers＆#39; choices of medical providers under New Rural Cooperative Medical Scheme（NRCMS） ,the author first handed out questionnaires and collected data from 1278 households in 66 counties of Shandong province .It was evident that more than 90% of them w ould like to choose medical institutions at county and village level .T hen using Nested Logit model ,the paper studied the determinants on these farmers＆#39;choice and found that ,on the first-level choice between higher and lower level medical institutions ,the farmers with elder age or chronic disease and those who consider NRCMS＆#39;s premium is too high ,are more likely to choose lower-level ,i .e ., county and village hospitals . While the farmers w ho have higher education , more reimbursement experiences ,larger reimbursement amount ,more convenient procedures and those who own commercial insurance ,are willing to choose higher-level ,i .e .,city hospitals or above .On the second-level choice among various medical institutions ,those providers with higher payment and quality ,higher rate of reimbursement and smaller distance are more popular ,and the former two factors are statistically significant .