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Outline
To systematically investigate the healthcare facility selection preferences and characteristics of insurance participation among basic medical insurance enrollees in Guangxi, with a focus on the influencing mechanisms of residents’ selection preferences, so as to provide empirical evidence and optimization pathways for advancing the integration of urban-rural medical insurance and deepening the implementation of the tiered diagnosis and treatment system.
A cross-sectional field survey was conducted among insured residents in 14 prefecture-level cities in Guangxi using a multi-stage random sampling method. A multinomial logit regression model was employed to systematically analyze the influence of demographic characteristics and medical insurance service factors on healthcarefacility selection preferences.
After incorporating variables with statistical significance in univariate analysis into multivariate Logit regression, household registration type(non-agricultural household registration, OR=0.410) and education level(high school or technical secondary school, OR=0.252; junior college and above, OR=0.273) were facilitators for choosing higher-level medical institutions. In contrast, medical insurance type(urban and rural resident medical insurance, OR=2.325) and hospitalization experience(no history of hospitalization, OR=3.151) were facilitators for choosing primary medical institutions. Payment pressure level was a facilitator for choosing high-level medical institutions. Patients who perceived payment pressure as “relatively high”(OR=0.330) or “general”(OR=0.203) were more inclined to choose tertiary medical institutions.
Household registration type and medical insurance type jointly influence insured residents’ choice of medical institution level. Hospitalization experience is a key health-related factor affecting such choices. Variations in perceived premium payment pressure lead to different preferences among insured residents in selecting medical institutions. Therefore, policies related to medical insurance and the tiered diagnosis and treatment system should be optimized accordingly.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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